Doctors Confirm 1st Case of HIV-2 in L.A.

Los Angeles physicians have confirmed the first West Coast case of infection with a variant AIDS virus called HIV-2, which is extremely rare in the United States but common in western Africa.

The patient is a West African man in his 30s who has lived in Los Angeles since 1979, physicians at Cedars-Sinai Medical Center and the Los Angeles County Department of Health Services said Tuesday. He had sought medical care for another condition and has not developed AIDS.

The variant virus “has made it here (to Los Angeles), but it is no big surprise,” said Dr. David Ho, director of AIDS virology at Cedars-Sinai. Ho’s laboratory established the diagnosis after the patient’s personal physician referred him to the hospital.

HIV-2, for human immunodeficiency virus two, can cause AIDS and related illnesses. Preliminary scientific evidence suggests that it is less virulent than the predominant AIDS virus, which is known as HIV-1.

Seven Cases in U.S.

In addition to the Los Angeles case, seven other HIV-2 cases have been confirmed in the United States over the last two years, mostly from northeastern states, according to Dr. Thomas O’Brien, a medical epidemiologist with the Centers for Disease Control in Atlanta. Six more cases are under investigation. All of these cases involve West Africans who appear to have acquired the virus in West Africa.

By comparison, there have been about 7,850 AIDS cases diagnosed in Los Angeles County since 1981, according to Dr. Peter Kerndt, director of the Department of Health Services’ AIDS epidemiology program. Between 57,000 and 112,000 county residents are estimated to be infected with HIV-1.

HIV-2 “seems to be limited to persons from western Africa at the present time,” Kerndt said. “We have not demonstrated any spread beyond that basic group.”

Public health officials believe that it is inevitable that the number of HIV-2 cases in the United States will increase gradually. But they do not expect it to reach anywhere near the prevalence of HIV-1, primarily because of increased public awareness of the AIDS virus and an improved ability to prevent transmission.

Like the original AIDS virus, HIV-2 can be transmitted through sexual intercourse and exposure to infected blood. American blood banks do not accept donations from West Africans. While blood donations are not specifically screened for HIV-2, standard blood tests for HIV-1 detect between 60% and 90% of HIV-2 cases, according to Ho and Kerndt.

The infected Los Angeles resident was born in Sierra Leone. As part of his medical evaluation, a blood test for HIV-1 was obtained. The results were inconclusive.

The patient was then referred to Ho at Cedars-Sinai for further testing. Ho’s laboratory performed additional blood tests that conclusively established the diagnosis of HIV-2 infection.

The man has never donated blood, used intravenous drugs or engaged in homosexual activity, Kerndt said. He has had between 20 and 40 heterosexual partners. Public health officials are seeking to contact his partners so that they can be tested for HIV-2. So far, one long-term heterosexual partner has tested negative.