Newsday - December 27, 1988
Laurie Garrett

No one knows whether HIV-2 will prove as lethal as its cousin, the common AIDS virus, or HIV-1. Although it shares some genetic similarity with HIV-1, HIV-2 is clearly a separate and mysterious species of virus.

While debate rages over its possible virulence, the virus is spreading, infecting massive numbers of Africans, predominantly in the western equatorial region of the continent.

The virus was discovered three years ago by competing teams of researchers from Harvard University and France's Pasteur Institute. To this day, the teams differ in their estimates of how lethal HIV-2 is.

Two years ago Dr. Max Essex of Harvard University said the deadly HIV-1 virus was getting competition from HIV-2 in the western region of Africa, and infection with HIV-2 somehow conferred immunity against HIV-1. According to Essex, people infected with HIV-2 not only remained healthy, but were actually able to resist infection by the deadly HIV-1 virus.

But Essex's co-worker Phyllis Kanki has studied a group of 300 prostitutes in Dakar, Senegal, for the past two years and has seen increasing numbers of the women, over time, testing positive for both HIV-1 and HIV-2. Today, she said, about 10 percent of the city's prostitutes are infected with one of the viruses.

Especially confounding is that although one in 10 of the women are infected, none have developed AIDS. The majority of the prostitutes of Dakar carry HIV-2, and, said Kanki, "HIV-2 is showing a quite distinct biology from HIV-1." Asked if people with HIV-2 will go on to develop full-blown AIDS, Kanki shrugged and said no one really knows. "It is possible HIV-2 is a less pathogenic virus," she said. "But it is also possible it is capable of remaining latent for longer periods of time before causing disease."

However, some people have developed AIDS, and died, as a result of HIV-2 infection. Dr. Luc Montagnier of the Pasteur Institute in Paris has studied the blood of these patients and found there is a large protein of unknown significance drifting through their bloodstreams. This mysterious protein is also found on the surface of cells infected by the HIV-2 virus. "We do not know what this is," said Montagnier, "but it is completely specific to HIV-2 infection." Researchers at the Pasteur Institute suspect the clue to determining exactly how dangerous HIV-2 is lies in understanding the role of this mysterious protein.

The question is certainly not academic.

HIV-2 is sweeping across parts of Africa at an alarming rate. If this virus is eventually going to cause AIDS in most persons it has infected, Africa's real nightmare has just begun.

Consider:

Dr. Wanda Canas Ferreira of the Institute of Hygiene and Tropical Medicine in Lisbon, found that HIV-2 was rampant in Guinea-Bissau (formerly Portuguese Guinea, in West Africa), and spreading fast. Eight years ago, she said, just 1 percent of the blood donors in the city of Bissau carried the virus; today 26 percent are infected. Infection among children in Bissau has jumped in eight years from zero known cases to nearly 10 percent. About 11 percent of the country's military recruits are HIV-2 carriers. In contrast, there is virtually no HIV-1 infection in the country.

A number of countries face both viruses simul taneously. In the Ivory Coast, for example, a little more than 2 percent of the pregnant women tested this year in hospitals around the country carried HIV-1, more than 4 percent were infected with HIV-2, and another 4 percent were co-infected with both HIV-1 and HIV-2.

Among prostitutes in Benin, Nigeria, overall HIV infection is less than 10 percent; 4.5 percent have HIV-1 and 3.7 percent carry HIV-2.

As the primary HIV-1 epidemic spreads outwards, apparently, from the Lake Victoria region in East Africa, the HIV-2 epidemic is moving to the south. Uganda, which has reported the most cases of AIDS on the continent, now finds that about 19 percent of the patients hospitalized in the capital city of Kampala carry both viruses.

And far to the southwest, in Angola, people undergoing treatment for other sexually transmitted diseases seem to be infected with both AIDS viruses. Eleven percent carry HIV-1, 10.5 percent have HIV-2, and 3.5 percent are infected simultaneously with both viruses.

"Nobody knows what this means," said Dr. James Chin, chief epidemiologist for the World Health Organization, "and we at WHO can't begin to factor in HIV-2 to predict the future of the African AIDS epidemic. We just don't know what is going to happen to these people." Scientists from Sweden and the United States claim to have found at least two other species of AIDS-like viruses on the African continent, although they are extremely rare. The significance, if any, of these discoveries is yet to be determined.
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