hello Dr Franscino,i have hiv 2 how will i know my viral loads and when is the best time to start the meds? do you have any information on how to manage hiv 2?

Hello, You will need the help of an experienced HIV specialist to help you with those decisions.

Here's what we know about HIV-2. Compared to HIV-1, HIV-2 is less transmissible (five- to eight-fold less efficient than HIV-1 in early-stage disease and it is rarely the cause of vertical transmission). HIV-2 infection is associated with lower viral loads and a slower rate of both CD4 cell decline and clinical progression. Nevertheless, mortality rates for HIV-1 and HIV-2 infections are similar when adjusted for viral load. Some patients may be coinfected with both HIV-1 and HIV-2. There are currently no treatment guidelines for HIV-2; however, most HIV specialists suggest the same clinical, viral load and CD4 count criteria used for HIV-1 be used for HIV-2 as well. HIV-2 is not susceptible to non-nucleoside reverse transcriptase inhibitors (NNRTIs), like Sustiva and Viramune. HIV-2 may also have multiple protease inhibitor-associated resistance mutations. There are no commercially available viral load assays or resistance profiles for HIV-2, although these tests can be performed by some specialty laboratories. Your HIV specialist will need to arrange for this for you.

Good luck.

Dr. Bob