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    An unexpected diagnosis of human immunodeficiency virus-2 infection in an overseas visitor: a case report.

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    Author
    Sohail, A; Van Leer, L; Holmes, N
    Date
    2017-03-04
    Source Title
    BMC Research Notes
    Publisher
    Springer Science and Business Media LLC
    University of Melbourne Author/s
    Holmes, Natasha
    Affiliation
    Medicine and Radiology
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Sohail, A., Van Leer, L. & Holmes, N. (2017). An unexpected diagnosis of human immunodeficiency virus-2 infection in an overseas visitor: a case report.. BMC Res Notes, 10 (1), pp.116-. https://doi.org/10.1186/s13104-017-2438-7.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/258197
    DOI
    10.1186/s13104-017-2438-7
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336689
    Abstract
    BACKGROUND: Human immunodeficiency virus 2 infection is endemic in West Africa but is also found in parts of Europe, North and South America, and India where it is thought to have been introduced secondary to migration and commercial trade ties. It is less common than Human immunodeficiency virus 1, with differences in pathogenicity, lower rates of transmission, longer asymptomatic period and slower progression to acquired immunodeficiency syndrome. Human immunodeficiency virus 2 is also associated with diagnostic challenges given the lack of commercially available diagnostic tests, and management challenges given intrinsic resistance to many anti-retroviral therapies. CASE PRESENTATION: We describe a case of a 65 year old South Indian female, visiting her family in Australia, who presented with weight loss, pancytopaenia and generalised lymphadenopathy on a background of newly diagnosed congestive cardiac failure. Multiple investigations were performed to elucidate the cause of her presentation, with the eventual unexpected diagnosis of human immunodeficiency virus 2. She was commenced on anti-retroviral treatment and made a remarkable recovery. CONCLUSION: We describe the challenges associated with diagnosis of human immunodeficiency virus 2 due to lack of commercially available diagnostics, as well as the treatment and management challenges including the fact that human immunodeficiency virus 2 is intrinsically resistant to non-nucleoside reverse transcriptase inhibitors. Human immunodeficiency virus 2 infection should be considered in patients who present with symptoms and signs that do not point towards a clear diagnosis, such as unexplained pancytopaenia or lymphadenopathy, and who have risk factors such as being from an endemic area or having had blood transfusions, especially prior to the commencement of blood-borne virus screening of blood donors.

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