Intrahost evolution of the HIV-2 capsid correlates with progression to AIDS.

HIV-2 infection will progress to AIDS in most patients without treatment, albeit at approximately half the rate of HIV-1 infection. HIV-2 capsid (p26) amino acid polymorphisms are associated with lower viral loads and enhanced processing of T cell epitopes, which may lead to protective Gag-specific T cell responses common in slower progressors. Lower virus evolutionary rates, and positive selection on conserved residues in HIV-2 env have been associated with slower progression to AIDS. In this study we analysed 369 heterochronous HIV-2 p26 sequences from 12 participants with a median age of 30 years at enrolment. CD4% change over time was used to stratify participants into relative faster and slower progressor groups. We analysed p26 sequence diversity evolution, measured site-specific selection pressures and evolutionary rates, and determined if these evolutionary parameters were associated with progression status. Faster progressors had lower CD4% and faster CD4% decline rates. Median pairwise sequence diversity was higher in faster progressors (5.7x10-3 versus 1.4x10-3 base substitutions per site, P<0.001). p26 evolved under negative selection in both groups (dN/dS=0.12). Median virus evolutionary rates were higher in faster than slower progressors - synonymous rates: 4.6x10-3 vs. 2.3x10-3; and nonsynonymous rates: 6.9x10-4 vs. 2.7x10-4 substitutions/site/year, respectively. Virus evolutionary rates correlated negatively with CD4% change rates (ρ = -0.8, P=0.02), but not CD4% level. The signature amino acid at p26 positions 6, 12 and 119 differed between faster (6A, 12I, 119A) and slower (6G, 12V, 119P) progressors. These amino acid positions clustered near to the TRIM5α/p26 hexamer interface surface. p26 evolutionary rates were associated with progression to AIDS and were mostly driven by synonymous substitutions. Nonsynonymous evolutionary rates were an order of magnitude lower than synonymous rates, with limited amino acid sequence evolution over time within hosts. These results indicate HIV-2 p26 may be an attractive therapeutic target.

HIV treatment in Guinea-Bissau: room for improvement and time for new treatment options.

Despite advances in the treatment quality of HIV throughout the world, several countries are still facing numerous obstacles in delivering HIV treatment at a sufficiently high quality, putting patients' lives in jeopardy. The aim of this status article is to give an overview of HIV treatment outcomes in the West African country, Guinea-Bissau, and to assess how newer treatment strategies such as long-acting injectable drugs or an HIV cure may limit or stop the HIV epidemic in this politically unstable and low-resource setting. Several HIV cohorts in Guinea-Bissau have been established and are used as platforms for epidemiological, virological, immunological and clinical studies often with a special focus on HIV-2, which is prevalent in the country. The Bandim Health Project, a demographic surveillance site, has performed epidemiological HIV surveys since 1987 among an urban population in the capital Bissau. The Police cohort, an occupational cohort of police officers, has enabled analyses of persons seroconverting with estimated times of seroconversion among HIV-1 and HIV-2-infected individuals, allowing incidence measurements while the Bissau HIV Cohort and a newer Nationwide HIV Cohort have provided clinical data on large numbers of HIV-infected patients. The HIV cohorts in Guinea-Bissau are unique platforms for research and represent real life in many African countries. Poor adherence, lack of HIV viral load measurements, inadequate laboratory facilities, high rates of loss to follow-up, mortality, treatment failure and resistance development, are just some of the challenges faced putting the goal of "90-90-90″ for Guinea-Bissau well out of reach by 2020. Maintaining undetectable viral loads on treatment as a prerequisite of a cure strategy seems not possible at the moment. Thinking beyond one-pill-once-a-day, long-acting antiretroviral treatment options such as injectable drugs or implants may be a better treatment option in settings like Guinea-Bissau and may even pave the way for an HIV cure. If the delivery of antiretroviral treatment in sub-Saharan Africa in a sustainable way for the future should be improved by focusing on existing treatment options or through focusing on new treatment options remains to be determined.

Evolutionary aspects on the origin, distribution and ramifications of the ischiadicus nerve in the giant anteater (Myrmecophaga tridactyla) / Aspectos evolutivos sobre as origens, distribuições e ramificações dos nervos isquiáticos do tamanduá-bandeira (Myrmecophaga tridactyla)

This work aimed to describe the origin, distribution, and ramifications of the ischiadicus nerve in the giant anteater and to provide anatomical data which could explain not only the evolutionary aspects but also provide important information for other related works. For the present study, four specimens were used, prepared by perfusion of 10% formaldehyde solution via the femoral artery, for conservation and dissection. The origin of the right and left ischiadicus nerves in the giant anteater from the ventral ramification of the third lumbar (L3) and the first (S1), second (S2), and third (S3) sacral spinal nerves. These nerves were symmetrical in all animals studied. The distribution and ramification occurred to the superficial, middle, and deep gluteal, gemelli, piriform, quadratus femoris, tensor fasciae latae, caudal crural abductor, cranial and caudal parts of the biceps femoris, adductor, semitendinous, and cranial and caudal parts of the semimembranous muscles. Based on the origins of the ischiadicus nerves, there is a caudal migration in the nerve location in animals in a more recent position on the evolutionary scale due to reconfiguration of the lumbosacral plexus, resulting from the increase in a number of lumbar vertebrae. There is no complete homology of the muscle innervation.(AU)

Objetivou-se descrever as origens, distribuições e ramificações dos nervos isquiáticos no tamanduá-bandeira, disponibilizando, assim, dados anatômicos que possam não só elucidar os aspectos evolutivos como também fornecer informações importantes para áreas afins. Foram utilizados quatro espécimes preparados por meio da perfusão de formaldeído 10% via artéria femoral, para conservação e dissecação. As origens dos nervos isquiáticos direito e esquerdo no tamanduá-bandeira foram provenientes dos ramos ventrais dos nervos espinhais lombares três e sacrais um, dois e três, sendo simétricos em todos os animais estudados. As distribuições e ramificações ocorreram nos músculos glúteos superficial, médio e profundo; gêmeo; piriforme; quadrado femoral; tensor da fáscia lata; abdutor crural caudal; bíceps femoral parte cranial; bíceps femoral parte caudal; adutor; semitendíneo; semimembranáceo parte cranial e semimembranáceo parte caudal. Notou-se que houve uma migração caudal na localização deste nervo nos animais mais recentes na escala evolutiva, devido a uma reconfiguração do plexo lombossacral decorrente do aumento no número de vértebras lombares, não havendo uma homologia total quanto à inervação dos músculos.(AU)

Long-term effects of smallpox vaccination on expression of the HIV-1 co-receptor CCR5 in women.

BACKGROUND: Smallpox vaccinations were stopped globally in 1980. Recent studies have shown that in women, being smallpox vaccinated was associated with a reduced risk of HIV infection compared with not being smallpox vaccinated. At the initial infection, HIV-1 most often uses CCR5 as a co-receptor to infect the T-lymphocytes. We therefore investigated whether smallpox vaccination is associated with a down-regulation of CCR5 on the surface of peripheral T-lymphocytes in healthy women in Guinea-Bissau. METHODS: We included HIV seronegative women from Bissau, Guinea-Bissau, born before 1974, with and without a smallpox vaccination scar. Blood samples were stabilised in a TransFix buffer solution and stained for flow cytometry according to a T-cell maturation profile. RESULTS: Ninety-seven women were included in the study; 52 with a smallpox vaccination scar and 45 without a scar. No association between smallpox vaccination scar and CCR5 expression was found in any T-lymphocyte subtype. CONCLUSION: Among HIV seronegative women, being smallpox vaccinated more than 40 years ago was not associated with a down-regulation of CCR5 receptors on the surface of peripheral T-lymphocytes.

The challenge of discriminating between HIV-1, HIV-2 and HIV-1/2 dual infections.

OBJECTIVES: Discrimination between HIV-1 and HIV-2 is important to ensure appropriate antiretroviral treatment (ART) and epidemiological surveillance. However, serological tests have shown frequent mistyping when applied in the field. We evaluated two confirmatory tests, INNO-LIA HIV I/II Score and ImmunoComb HIV 1/2 BiSpot, for HIV type discriminatory capacity. METHODS: Samples from 239 ART-naïve HIV-infected patients from the Bissau HIV Cohort in Guinea-Bissau were selected retrospectively based on the initial HIV typing performed in Bissau, ensuring a broad representation of HIV types. INNO-LIA results were interpreted by the newest software algorithm, and three independent observers read the ImmunoComb results. HIV-1/HIV-2 RNA and DNA were measured for confirmation. RESULTS: INNO-LIA results showed 123 HIV-1 positive samples, 69 HIV-2 positive and 47 HIV-1/2 dually reactive. There was agreement between INNO-LIA and HIV-1/HIV-2 RNA and DNA detection, although not all HIV-1/2 dually reactive samples could be confirmed by the nucleic acid results. Overall, the observers found that the ImmunoComb results differed from the INNO-LIA results, with agreements of 90.4, 91.2 and 92.5%, respectively, for HIV-1, HIV-2 and HIV-1/2. The combined kappa-score for agreement between the three observers was 0.955 (z-score 35.1; P < 0.01). Of the HIV-2 mono-reactive samples (INNO-LIA), the three observers interpreted 24.6-31.9% as HIV-1/2 dually infected by ImmunoComb. None of these samples had detectable HIV-1 RNA or DNA. CONCLUSIONS: There was accordance between INNO-LIA calls and nucleic acid results, whereas ImmunoComb overestimated the number of HIV-1/2 dually infected patients. Confirmatory typing is needed for patients diagnosed with HIV-1/2 dual infection by ImmunoComb.

Effects of high concentrations of dietary crude glycerin on dairy cow productivity and milk quality.

An increasing worldwide interest in alternative fuel sources and in a more diversified energy matrix has provided incentives for the biodiesel industry, generating large amounts of the by-product crude glycerin, a potential alternative feed for dairy cows. A replicated 3×3 Latin square study was conducted to evaluate the effects of high concentrations of crude glycerin on dry matter intake, milk yield and composition, milk fatty acid profile, and blood metabolites of medium-yield cows. Ruminally cannulated Holstein cows (n=6; 587 ± 39 kg of body weight; 114 ± 29 d in milk; and 20 ± 1.5 kg/d milk yield) were used in the study. The experimental period included 2 wk for adaptation and 1 wk for data collection. Cows were fed diets containing 0 (control), 15, or 30% crude glycerin (83% glycerol). Cows were milked, milk weights were recorded twice daily, and milk samples were collected for milk quality analyses at d 18 and 19 in each experimental period. Feeding cows with crude glycerin linearly decreased dry-matter intake, the 3.5% fat-corrected milk, and the solid-corrected milk yield. Hepatic enzymes were not affected by dietary treatments, except gamma-glutamyl transferase, which was decreased with the 15% crude glycerin diet. Serum glucose and albumin showed quadratic effect with increasing inclusion of crude glycerin. Plasma cholesterol as well as total protein linearly decreased with increasing inclusion of crude glycerin. Milk fat concentration and yield showed a quadratic effect of treatments. Solid yield decreased linearly with increasing inclusion of crude glycerin. Odd-chain fatty acids and conjugated linoleic acid in milk fat linearly increased with addition of crude glycerin in the diets. Together, these results suggest that crude glycerin has potential to replace corn; however, feeding diets in which corn is replaced with crude glycerin at 30% of dietary DM greatly reduces animal performance.

Rationale for individualizing haemophilia care.

Owing to the heterogeneity in the clinical phenotype of haemophilia A and B, it is now recognized that disease severity (based on factor VIII/IX activity) may no longer be the most appropriate guide for treatment and that a 'one-size-fits-all' approach is unlikely to achieve optimal therapy. Based on the present literature and consensus views of a group of experts in the field, this article highlights key gaps in the understanding of the diverse relationships between bleeding phenotype and factors such as joint health, genetic susceptibility, laboratory parameters, quality of life and management of pain. Early prophylaxis is a potential 'gold standard' therapy and issues surrounding inhibitor development, variations in its clinical use and long-term outcomes are discussed. Comprehensive treatment should be individualized for all patients (including those with mild or moderate haemophilia and carriers). Wherever possible all patients should be given prophylaxis. However, adult patients with a milder haemophilia phenotype may be candidates for ceasing prophylaxis and switching to on-demand treatment. Regardless, all treatment (on-demand and prophylaxis) should be tailored towards both the patient's personal needs and their clinical profile. In addition, as the associations between risk factors (psychosocial, condition-related and treatment-related) and clinical features are unique to each patient, an individualized approach is required to enable patients to alter their behaviour in response to them. The practical methodologies needed to reach this goal of individualized haemophilia care, and the health economic implications of this strategy, are ongoing topics for discussion.

Descriptive anatomic study of the great vessels of the heart in the capuchin monkey Cebus apella (Linnaeus, 1758).

The aim of this study was to describe the anatomy of the great vessels of the heart in capuchin monkey (Cebus apella) and to compare with those of other primates, including humans. The hearts were prepared through fixation in 10% formalin and subsequently dissected using standard techniques and instruments. The arterial and venous systems were perfused with colored latex solution via the femoral vessels. An ascending cylindrical branch with relatively great caliber was identified in the aorta artery, in addition to an aortic arch, from which three great arteries were originated, the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. After a course of variable extension, the pulmonary trunk divided into right and left pulmonary arteries. The caudal vena cava was morphologically similar to that of humans, except for its association with the cardiac lobe of the right lung, whereas the cranial vena cava was formed by the two braquiocephalic veins and received the azygos vein close to right atrium. The pulmonary veins, in number of six, ended at the posterior face of the left atrium, differently from both humans and other primates. In conclusion, the morphology of the great vessels of the heart in Cebus apella was similar to that of humans and other primates, although some differences are evidenced with regards to topography and number of anatomic structures, particularly the relationship of the caudal vena cava with the cardiac lobe of the right lung and the presence of six pulmonary veins in Cebus apella.

Recombinant factor VIIa analog (vatreptacog alfa [activated]) for treatment of joint bleeds in hemophilia patients with inhibitors: a randomized controlled trial.

BACKGROUND: A recombinant factor VIIa analog (NN1731; vatreptacog alfa [activated]) was developed to provide safe, rapid and sustained resolution of bleeds in patients with hemophilia and inhibitors. PATIENTS/METHODS: This global, prospective, randomized, double-blinded, active-controlled, dose-escalation trial evaluated and compared one to three doses of vatreptacog alfa at 5, 10, 20, 40, and 80 lg kg(-1) with one to three doses of recombinant FVIIa (rFVIIa) at 90 lg kg(-1) in the treatment of acute joint bleeds in hemophilia patients with inhibitors. The primary endpoint comprised adverse events; secondary endpoints were evaluations of immunogenicity, pharmacokinetics, and efficacy. RESULTS AND CONCLUSIONS: Overall, 96 joint bleeds in 51 patients (> 12 years of age) were dosed. Vatreptacog alfa was well tolerated, with a low frequency of adverse events. No immunogenic or thrombotic events related to vatreptacog alfa were reported. A high efficacy rate of vatreptacog alfa in controlling acute joint bleeds was observed; 98% of bleeds were controlled within 9 h of the initial dose in a combined evaluation of 20­80 lg kg(-1) vatreptacog alfa. The efficacy rate observed for rFVIIa (90%) is consistent with data from published clinical trials. The trial was not powered to compare efficacy, and further trials are needed to investigate the efficacy of vatreptacog alfa as compared with that of rFVIIa. The trial was registered at ClinicalTrials.gov ( REGISTRATION NUMBER: NCT00486278).

High prevalence of HIV-1, HIV-2 and other sexually transmitted infections among women attending two sexual health clinics in Bissau, Guinea-Bissau, West Africa.

The objective was to examine the prevalence of HIV-1, HIV-2 and 10 other sexually transmitted infections (STIs), and to explore the relationship between HIV and those STIs in women attending two sexual health clinics in Bissau, Guinea-Bissau. In all, 711 women with urogenital problems were included. Clinical examination was performed and HIV-1, HIV-2, human T-cell lymphotropic virus (HTLV)-1, HTLV-2 and syphilis were diagnosed by serology. Trichomonas vaginalis was examined using wet mount microscopy. Cervical samples (and swabs from visible ulcers, if present) were used for polymerase chain reaction (PCR) diagnosis of Chlamydia trachomatis, Mycoplasma genitalium, Haemophilus ducreyi, herpes simplex virus (HSV)-1 and HSV-2, and culture diagnosis of Neisseria gonorrhoeae. The prevalence of HIV-1, HIV-2, and HIV-1 and HIV-2 (dual infection) was 9.5%, 1.8% and 1.1%, respectively. The prevalence of HTLV-1 was 2.8%, HTLV-2 0%, HSV-1 1.4%, HSV-2 7.7%, T. vaginalis 20.4%, syphilis 1.0%, N. gonorrhoeae 1.3%, H. ducreyi 2.7%, M. genitalium 7.7% and C. trachomatis 12.6%. HIV-1 and/or HIV-2 infection was significantly associated with active HSV-2 and HIV-1 was significantly associated with M. genitalium infection. In conclusion, HIV-1 and HIV-2 prevalence was higher compared with previous studies of pregnant women in Guinea-Bissau. The prevalence of co-infection of HIV and other STIs is high. National evidence-based guidelines for the management of STIs in Guinea-Bissau are essential.

[Cross sectional geriatric assessment of free living older subjects from Antofagasta, Chile]. / Valoración multidimensional del envejecimiento en la ciudad de Antofagasta.

BACKGROUND: The effects of aging on people must be evaluated to adequate sanitary actions. AIM: To assess the characteristics of older subjects living in Antofagasta, Chile. MATERIAL AND METHODS: Cross sectional assessment of 602 subjects without dementia, aged more than 60 years (55% females). A socioeconomic and medical history was obtained and Barthel, Lawton, Yesavage depression, Tromp fall risk and Folstein Mini mental scales were applied. RESULTS: Sixty eight percent of subjects had more than six years of studies. Forty six percent had hypertension, 28% had osteoarticular problems, 20% had hypercholesterolemia and 17% diabetes mellitus. Four percent had depression and falls were reported by 35%. Seventy four percent were independent in basic and instrumental activities. Ninety four percent had normal cognitive functions. Age was an important determinant of functional capacity. CONCLUSIONS: The main problems detected in this sample were the risk of falls and the presence of chronic diseases.

Valoración multidimensional del envejecimiento en la ciudad de Antofagasta / Cross sectional geriatric assessment of free living older subjects from Antofagasta, Chile

Background: The effects of aging on people must be evaluated to adequate sanitary actions. Aim: To assess the characteristics of older subjects living in Antofagasta, Chile. Material and Methods: Cross sectional assessment of 602 subjects without dementia, aged more than 60 years (55 percent females). A socioeconomic and medical history was obtained and Barthel, Lawton, Yesavage depression, Tromp fall risk and Folstein Mini mental scales were applied. Results: Sixty eight percent of subjects had more than six years of studies. Forty six percent had hypertension, 28 percent had osteoarticular problems, 20 percent had hypercholesterolemia and 17 percent diabetes mellitus. Four percent had depression and falls were reported by 35 percent. Seventy four percent were independent in basic and instrumental activities. Ninety four percent had normal cognitive functions. Age was an important determinant of functional capacity. Conclusions: The main problems detected in this sample were the risk of falls and the presence of chronic diseases.

[Urinary nickel in children exposed to petcoke pollution]. / Nivel de níquel urinario en niños residentes en ciudades cercanas a megafuentes.

BACKGROUND: Petcoke is a remnant of the oil refining process that contains Ni and other heavy metals. Undesired human exposure to these compounds may result from petcoke combustion in plants located in the vicinity of the cities. AIM: To compare levels of urinary Ni in schoolchildren residing in cities exposed and not exposed to petcoke pollution. MATERIAL AND METHODS: A cross sectional study was done in schoolchildren aged 7 to 8 years old in two cities in northern Chile: Mejillones (n = 59), near to a petcoke plant, and Tocopilla (n = 56) as the reference city. First, morning urinary samples were collected and urinary Ni was determined by Atomic Absorption Spectrometry. Socioeconomic and environmental exposure information of families was obtained applying a questionnaire to parents. Multiple linear regression was performed to identify other variables that may explain urinary Ni differences among the cities. RESULTS: Median level of Ni was higher in Mejillones (4.9 fig/L) than in Tocopilla (3.9 fig/L). Residing in the exposed city was the most important explaining factor (B = 0.26; IC 0.107 - 0.428). Additionally years of residency was associated with urinary Ni (B = 0.03; IC 0.004 - 0.060). CONCLUSIONS: Urinary Ni in schoolchildren is higher in the city exposed to petcoke emissions. The difference does not imply that there are concrete hazards for the population's health. However, it warns about the existence of a higher exposure in places where petcoke is used.

Nivel de níquel urinario en niños residentes en ciudades cercanas a megafuentes / Urinary nickel in children exposed to petcoke pollution

Background: Petcoke is a remmant of the oil refiningprocess that contains Ni and other heavy metáis. Undesired human exposure to these compounds may result from petcoke combustión in plants located in the vicinity ofthe cities. Aim: To compare levéis of urinary Ni in schoolchildren residing in cities exposed and not exposed to petcoke pollution. Material and methods: A cross sectional study was done in schoolchildren aged 7 to 8 years oíd in two cities in northern Chile: Mejillones (n = 59), near to a petcoke plant and Tocopilla (n = 56) as the reference city. First, morning urinary samples were collected and urinary Ni was determined by Atomic Absorption Spectrometry. Socioeconomic and environmental exposure information of families was obtained applying a questionnaire to parents. Múltiple linear regression was performed to identify other variables that may explain urinary Ni differences among the cities. Results: Median level of Ni was higher in Mejillones (4.9 fig/L) than in Tocopilla (3.9 fig/L). Residing in the exposed city was the most important explaining factor (B = 0.26; IC 0.107 - 0.428). Additionally years of residency was associated with urinary Ni (B = 0.03; IC 0.004 - 0.060). Conclusions: Urinary Ni in schoolchildren is higher in the city exposed to petcoke emissions. The difference does not imply that there are concrete hazards for the population s health. However, it warns about the existence of a higher exposure in places where petcoke is used.

Esofagitis tuberculosa en un paciente HIV positivo / Esophageal tuberculosis. Repon of one case with aids

Tuberculosis rates in Chile are higher than expected during the last years. This is directly related to the increase of immunodeficiency associated to human immunodeficiency virus (HIV) infection. Gastrointestinal tuberculosis is the sixth in frequency of extra pulmonary localizations. We report an HIV(+) 55 year-old male, that presented with fever and epigastric pain. In an upper GI endoscopy small elevated lesions were described in the esophagus. Pathological study was suggestive of tuberculous infection. The definitive diagnosis of esophageal tuberculosis was obtained by a PCR test of the biopsy sample. Antituberculous therapy was started and one year later there was a regression but not disappearance of esophageal lesions and granulomas in the pathological study.

[Esophageal tuberculosis. report of one case with AIDS]. / Esofagitis tuberculosa en un paciente HIV positivo.

Tuberculosis rates in Chile are higher than expected during the last years. This is directly related to the increase of immunodeficiency associated to human immunodeficiency virus (HIV) infection. Gastrointestinal tuberculosis is the sixth in frequency of extra pulmonary localizations. We report an HIV(+) 55 year-old male, that presented with fever and epigastric pain. In an upper GI endoscopy small elevated lesions were described in the esophagus. Pathological study was suggestive of tuberculous infection. The definitive diagnosis of esophageal tuberculosis was obtained by a PCR test of the biopsy sample. Antituberculous therapy was started and one year later there was a regression but not disappearance of esophageal lesions and granulomas in the pathological study.

Modelos de regresión y correlación / Regression and correlation models

En este número de C&T iniciamos una serie de artículos dedicados al tema de regresión y correlación. En este artículo se definen y explican los conceptos básicos de regresión lineal y correlación. Se explica cómo opera y cómo aplicar un modelo de regresión lineal simple, así como la interpretación de la información obtenida. Se detallan los supuestos que deben chequearse y cumplirse para que el modelo sea válido y la importancia de evaluar los datos en forma gráfica, antes de cualquier análisis multivariado. Este artículo no pretende reemplazar libros especializados en el tema, pero sí dar una visión general que permita entender cómo operan estos modelos y cuáles son sus virtudes y debilidades.

Inferir o no inferir es la pregunta / To infer or not to infer: that is the question

No es raro disponer de información que no proviene de una muestra estrictamente aleatoria y se nos plantea el dilema de si es procedente o no enunciar conclusiones referidas a la población de la cual se extrajo esa muestra. Se discuten algunas consideraciones referentesa la decisión de extrapolar o no de la muestra a la población.

Human immunodeficiency virus (HIV)-2-specific T lymphocyte proliferative responses in HIV-2-infected and in HIV-2-exposed but uninfected individuals in Guinea-Bissau.

Human immunodeficiency virus (HIV)-2-specific T lymphocyte proliferative responses were determined in cultures of peripheral blood mononuclear cells from HIV-2-exposed uninfected individuals, HIV-2-infected individuals and HIV-negative controls in Guinea-Bissau. Increased HIV-2-specific T lymphocyte proliferative responses were detected in both groups compared to HIV-negative controls (healthy HIV-uninfected individuals without known exposure to an HIV-infected person); five out of 29 of the HIV-2-exposed uninfected and half (16 of 32) of the HIV-2-infected individuals had stimulation indexes >2, compared to one out of 49 of the HIV-negative controls (P = 0.003 and P < 0.0001, respectively). The exposed uninfected individuals had reactivity to a HIV-2 V3-peptide corresponding to amino acids 311-326 of the envelope glycoprotein, while the HIV-2-infected people reacted mainly to HIV-2 whole viral lysate. Thus, this study demonstrates a high degree of HIV-2-specific T helper cell activity, as measured by lymphocyte proliferation, in HIV-2-exposed uninfected individuals as well as in HIV-2-infected subjects. These immune responses could be important for resistance to the infection and for the control of established infection and, thus, play a role in the lower transmission and progression of HIV-2 compared to HIV-1.