Manipur, a north-eastern state of India bordering Myanmar, observed introduction of HIV-1 among fairly large number of IDUs in October 1989, followed by rapid spread within the next 6 months. HIV-2 in injectors was not present until recently, though it was detected from other parts of India in 1991. This communication reports for the first time presence of HIV-2 among young injectors of Manipur. All the HIV-2 infected IDUs were also found to be infected with HIV-1. HIV-2 has affected a large number of people in Africa through heterosexual transmission. It remains to be seen whether HIV-2 spreads rapidly also among the drug-injecting population of Manipur. Observation of the disease progression among HIV-2 infected IDUs will also be of interest.
PIP: HIV-1 was first detected in India in 1986. HIV-2 was first detected in the country in 1991 when paid blood donors and STD clinic attenders in north India tested seropositive for the virus. HIV-2 was later detected in Bombay and Goa. HIV-2 was also introduced in Madras and followed by an exponential increase in 1992 where heterosexual transmission was found to be responsible for the spread of the virus. 433 blood samples were collected and screened during the second quarter of 1994 from blood donors, injecting drug users (IDUs), and clinically suspected HIV disease cases admitted to the Regional Medical College (RMC) Hospital or treated at the outpatient department. 60.5% of IDUs tested positive for HIV-1, 6.6% were infected with both HIV-1 and HIV-2, and none were found to be infected exclusively with HIV-2. HIV-infected IDUs were aged 15-35 years and exclusively male. Most clinically suspected cases were young males attending the various departments of RMC with a history of long continued diarrhea, herpes zoster, extreme weight loss, miliary pulmonary tuberculosis, extrapulmonary tuberculosis, or pericardial effusion. Their histories suggested that many were IDUs, while a few only gave histories of unprotected sex with commercial sex workers. The report of a possible link between IDUs of Manipur and Madras suggests that HIV-2 may have come from Madras. The study of dual infection with both HIV-1 and HIV-2 among the IDUs may help in understanding the factors responsible for the efficient transmission of the two viruses. An extensive literature search found that HIV-2 among IDUs has previously been reported only from Spain approximately two years earlier.