Epidemiology and management of HIV-2.

Eholié, Serge Paul; Charpentier, Charlotte; Diallo, Zelica; Adama, Oumarou I Wone; da Silva Té, David; Descamps, Diane; Ekouevi, Didier Koumavi · Lancet HIV · 2026

review · Level V

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Abstract

HIV-2 remains a neglected component of the global HIV epidemic, predominantly affecting west Africa but also present in Europe and other regions through historical and migratory links. Although generally characterised by lower transmissibility and slower disease progression than HIV-1, HIV-2 poses distinct diagnostic, therapeutic, and programmatic challenges. Research, implementation, and advocacy efforts aimed at reducing HIV-2 infection must account for the limitations of available typing tools, the restricted access to validated viral load assays, the virus' intrinsic resistance to certain antiretroviral drug classes, and the gaps in retention in care that hinder progress towards global treatment targets. Strengthening collaborative research, improving diagnostic capacity, and integrating HIV-2 into broader HIV policy frameworks are essential to optimise patient outcomes and to advance the global HIV response.