How benign is HIV-2?

A cohort of police officers from Guinea-Bissau were followed
from 1990 until 2013. HIV-testing was performed regularly
and a total of 872 participants were diagnosed with HIV-infection.
408 of those were infected with HIV-1 and 467 were infected
with HIV-2. Time of infection was estimated as the midtimepoint
between last negative and first positive HIV-test.
Kaplan-Meir analysis of time to progression to AIDS and death
were performed. Median survival time from HIV-2 infection
to development of AIDS was 14.3 years compared to 6.2 years
for HIV-1. Median survival time was 15.6 versus 8.2 years. CD4
count declined more rapidly in HIV-1 compared to HIV-2 though
AIDS developed at higher CD4 counts in HIV-2 compared to HIV-1

Ref; Esbjornsson et al. Lancet HIV 2018: S2352-3018(18)30254-6. doi: 10.1016/
S2352-3018(18)30254-6

Comment: Though the progression to AIDS and death in HIV-
2 infection is slower than in HIV-1 infection the present study
shows that there is a high probability of progression to AIDS
and death also in HIV-2. The optimal time to start antiretroviral
treatment is still not defined. One could argue that there is
very little reason to delay treatment and that immediate initiation
of therapy may be reasonable.