HIV-1 versus HIV-2: What’s the Difference?

The human immunodeficiency virus is classified into two main types: HIV-1 and HIV-2. HIV-1 was discovered first and is more prevalent worldwide, while HIV-2 is less pathogenic and is mostly confined to West Africa. So when we generally say HIV, we are referring to HIV-1. The fundamental differences between HIV-1 and HIV-2 infections lie in the mechanism of retroviral pathogenesis, which is not fully clear yet.

According to the Centers for Disease Control and Prevention (CDC), 166 HIV cases in the US identified between 1988 and 2010 met the center’s definition of HIV-2 infection. The majority of cases were reported in the Northeast and either originated from or were linked to West Africa.

Digital illustration of HIV Virus in Blood Stream. Image Copyright: RAJ CREATIONZS / Shutterstock

Digital illustration of HIV Virus in Blood Stream. Image Copyright: RAJ CREATIONZS / Shutterstock

Diagnostic Tests

Early tests devised to detect one of these viruses will not detect the other due to the differences in the genetic makeup of these viruses. Over 55% of the genetic material is different in these viruses. Reports also suggest that the cross reactivity between antibodies of HIV-1 and HIV-2 may lead to misdiagnosis and under-reporting of HIV-2 infections. Immunoassays that can differentiate between both types are available nowadays and can help identify the specific type of HIV infection.

Disease Progression

HIV-1 and HIV-2 have many similarities including their intracellular replication pathways, transmission modes and clinical effects leading to acquired immune deficiency syndrome (AIDS). However, HIV-2 is less likely to progress into AIDS because of its lower transmissibility. Thus, individuals infected by HIV-2 mostly remain non-progressors for a long period of time, while patients infected by HIV-1 progress faster and contract AIDS.

However, once they progress, the pathological process for both viruses is largely similar, though HIV-2 is found to progress at higher CD4 counts. HIV-2 infections are characterized by lower viral loads of over 10,000 copies/mL compared to millions of copies/mL of HIV-1. However, the body’s immune response is more protective in the case of HIV-2 infection thus slowing down disease progression. If this immune response can be replicated, it can be used to delay disease progression in HIV-1 infected patients,  increase survival rates and reduce dependence on antiretroviral therapy.

Subdivisions of HIV-1 and HIV-2

HIV-1 and HIV-2 are further divided into groups and subtypes. HIV-1 is divided into main or M group, outlier or O group and non-M / O or N group, the most common of them being group M, which is mostly responsible for the HIV epidemic worldwide. The other 3 groups are relatively uncommon and are seen in select geographies including Gabon, Cameroon and Equatorial Guinea.

Group M is further divided into genetically distinct subtypes: A, B, C, D, F, G, H, J and K. Some of these subtypes combine to form a hybrid virus called ‘circulating recombinant form’. Subtype B is the dominant HIV-1 subtype found in the Americas, Australasia, and Western Europe and hence most of the clinical research on HIV is focused on these populations.

Globally, subtype B accounts for just 12% of HIV infections. Although subtype C represents almost 50% of all HIV affected individuals, lesser research has focused on this subtype. Subtype C is commonly found in countries in Southern Africa, where the incidence of HIV is very high. Cameroon and the Democratic Republic of Congo, the region of origin of HIV-1, have great diversity of HIV-1 subtypes. However, the pattern of subtype distribution across the globe is changing now, due to population mixing and migration.

The two main subtypes of HIV-2 that are considered epidemic are A and B, though in total there are about 8 HIV-2 subtypes identified so far. HIV-2 group A infections are mostly seen in West Africa, though a few cases have been reported in Brazil, Europe, US and India. HIV-2 group B infections are seen only in West Africa.

WikiLeaks exposes fallout over Clinton remarks on HIV/AIDS

The gaffe Hillary Clinton made in March crediting the Reagans with starting a “national conversation” on HIV/AIDS  angered many of her LGBT supporters and created stress in the campaign before she issued an apology reflecting on the epidemic, according to campaign emails made public by WikiLeaks over the weekend.

Shortly after Clinton made the remarks in March on MSNBC during Nancy Reagan’s funeral, she issued an apology in which she said she “misspoke” about the Reagans’ record, but Clinton supporters outside the campaign insisted that wasn’t enough.

Richard Socarides, a gay New York-based Democratic activist and Clinton supporter, emailed senior campaign officials to warn them the candidate should address the issue “before this spins out of control.”

“Nancy Reagan in fact helped start a national conversation about HIV and AIDS but as we all know it was far too little and way too late,” Socarides wrote. “When Bill Clinton ran for president in 1992 it was on a platform that was highly critical of the Republican response to the HIV crisis. It had been a record of neglect. As first lady and as senator and as Secretary of State Hillary has been a champion for increased funding and raising awareness.”

Echoing Socarides’ comments in a subsequent email was Steve Elemendorf, a gay Democratic lobbyist, who said he “cannot overstate how big a problem” the remarks were and called for immediate action from the campaign.

Kristina Schake, a deputy communications director for the Clinton campaign, wrote in another email that Clinton ally and Human Rights Campaign President Chad Griffin was receiving complaints about Clinton’s remarks and his response, which condemned the remarks but didn’t reference the candidate herself.

“I stayed with Chad last night who was receiving lots of angry calls and notes from people that he didn’t call her out by name,” Schake wrote. “He wouldn’t do that to her and kept stressing she just made a mistake, but suggested we need to do something more today to protect her. She has a great record and we lost a lot of ground messaging-wise.”

Dominic Lowell, the Clinton’s campaign LGBT liasion, distributed an email to coordinate the response, saying “most people are expressing palpable anger and hurt over the comments” in the last 24 hours over the remarks.

“If I had to break things down, I’d put people into three categories: 1) supporters who were horrified at the comment but accept the apology; 2) supporters who are angry and can only be mollified with a longer statement, tv appearance, roundtable, or something else big that shows she ‘gets it,’” Lowell wrote. “They will continue to make hay in the meantime; and 3) Bernie folks who are happy to have a new line of attack.”

(Indeed, Sen. Bernie Sanders, Clinton’s opponent in the Democratic primary, in the aftermath of Clinton crediting the Reagans for their efforts on HIV/AIDS said on CNN’s “State of the Union” he doesn’t “know what she was talking about.”)

Lowell expressed concern about the second group whom he identified, which he said consist of “Queer Nation, ACT UP, and other activists who are out, loud, and not afraid of direct action or aggressive confrontation,” adding he didn’t “want this to fester.”

Possibilities Lowell raised as a response included bumping up the HIV/AIDS policy roll out or putting together a roundtable. Lowell said Robbie Kaplan, a Clinton supporter and the attorney who successfully argued against the Defense of Marriage Act, had volunteered the New York-based Gay Men’s Health Crisis to assist with the effort.

(The exchange reveals the idea of a roundtable with HIV/AIDS activists, which was publicly requested after the remarks and occurred months later, was under consideration at this time.)

Teddy Goff, a technology strategist for Clinton, writes the problem with the candidate is supporters don’t understand “on a fact level, what happened and how she could have gotten so mixed up.”

“And in the absence of any explanatory information, they assume the worst — like that this was some cynical political strategy of ours,” Goff wrote. “(Which, I would note, makes no sense — why would our strategy be to piss everyone off? — but regardless.)”

Jessica Morales Rocketto, digital organizing director for the Clinton campaign, raised the possibility of responding in the “Out for Hillary” Facebook group, which she said had 14,000 members and “the largest LGBT community of Hillary’s supporters I know.”

“These are friendlies, they are already carrying water for us making sure the apology is out there, and they firmly sit in groups 1 and 2 that Dom identified,” Rocketto said.

Rocketto added sending talking points out to supporters “really worked” because “they are popping up everywhere on the supporter Facebook groups.”

Recognizing a distinction between younger and older Clinton supporters, Dennis Cheng, national finance director for the Clinton campaign, said using the groups would be helpful, but not enough because “a lot of our people (esp those who are older who lived through the 80s) want to see and hear her address it directly, given that they saw and heard her Reagan remarks on TV.”

After Robbie Mook, who’s gay and Clinton’s campaign manager, wrote in a subsequent email a Medium post would be a good opportunity for Clinton to express herself, the campaign settled on that course of action.

“She could open it by saying she misspoke and apologizes for that and wanted to make sure people understand what she will do,” Mook wrote.

Megan Rooney, speechwriter for Hillary Clinton, issued the first draft of the Medium post. In the initial draft, Clinton was to say she was wrong about the Reagans and “said so right away,” but those words were omitted after Goff wrote he didn’t think “that gets us any extra credit” and sounded “a hair defensive.”

Schake followed up with edits from Griffin, who changed the draft to more clearly state Clinton was sorry “for the pain my comments caused” and the persistence of HIV/AIDS among gay and bisexual men, transgender people and communities of color. Rooney said the chances of Clinton “OK-ing this statement with that top are slim” and the campaign would walk that back, although the phrase “made a mistake” remained in the final writing.

As Xochitl Hinojosa, the Clinton campaign’s LGBT media spokesperson, raised concern about upcoming stories in the LGBT media intending quote Clinton supporters who say the apology isn’t enough, the campaign scrambled to get approval and put the statement online.

“I think we really should do everything we can to get this up today, if at all possible (fingers crossed),” wrote Clinton campaign director of content and creative Lauren Peterson. “Does not seem to be dying down online, either.”

After approval by Clinton — and a few additional tweeks, including the removal of a reference to increase funding for PEPFAR in favor of a more general plan for “global funding” — publication was initially set to go, then halted for additional tweeks. A reference to “brave men and women” who fought HIV/AIDS was changed to “brave lesbian, gay, bisexual, and transgender people, along with straight allies.”

The final Medium post has Clinton asserting she was wrong about the Reagans and touting her record in speaking out in favor of efforts to combat HIV/AIDS at the domestic and international levels and mentioned her plan to achieve an “AIDS-free generation.” Among the proposals in the draft were extending Medicaid, reforming HIV criminalization laws, capping out-of-pocket drug expenses for HIV/AIDS medications and expanding access to PrEP.

“We’ve come a long way,” Clinton says in the post. “But we still have work to do to eradicate this disease for good and to erase the stigma that is an echo of a shameful and painful period in our country’s history.”

When the statement when online, staffers responded with jubilation. Jennifer Palmieri, the Clinton campaign’s director of communications, wrote, “Praise, Jesus!” Clinton campaign spokesperson Dan Schwerin commended his colleagues for the post and called it “amazing actually.”

Praise also came from outside the campaign. Jenna Lowenstein, digital director for the Clinton campaign wrote on Medium “the top comments are overwhelmingly positive (and some are quite moving).” Lowell passed around a statement from former Human Rights Campaign President Joe Solmonese, who said the post “literally brought [a] tear to my eyes,” and from another statement from AIDS activist Larry Kramer, who was angered with Clinton’s remarks, but satisfied with the Medium post.

Ann O’Leary, senior policy adviser for the Clinton campaign, shared a message she said came from a couple, Viki and Jen, who were among the couples to marry in San Francisco by then-Mayor Gavin Newsom in 2004.

“Jen and I wanted to tell you how incredibly impressed we were with HRC when she was able to apologize for what she said about the Reagans etc. in such a remarkably humble and authentic way,” the message reads. “She showed true leadership, something we are not seeing a lot of these days. We are so proud of her and moved by her courage to open herself up publicly in this manner. Definitely presidential material!!”

Even though Clinton twice apologized for the remarks and recommitted herself to fight HIV/AIDS in the aftermath, it remains unclear why she made the remarks in the first place. Some have speculated she confused Nancy Reagan’s work on Alzheimer’s disease with HIV/AIDS; others claims the remarks were an effort to curry favor with Reagan Democrats.

As foreshadowed in the emails, Clinton would take part in a meeting with HIV/AIDS activists and recommitted herself to fighting the epidemic. Sanders scheduled a meeting with HIV/AIDS activists at the same time as Clinton, but later cancelled the meeting on short notice, then rescheduled in California before the primary in that state.

The Washington Blade has placed a call to the Clinton campaign seeking comment on the leaked emails. The Clinton campaign hasn’t publicly acknowledged, nor denied, the veracity of the messages in the WikiLeaks dump.


It is certainly no secret that Donald Trump supporters are not the biggest fans of Hillary Clinton. The host of The Daily Show on Comedy Central decided to blend into a Donald Trump rally to see what Donald Trump supports had to say about Hillary Clinton’s health, body double, and all the other conspiracy theories that have been floating around as of late.

What is the latest Hillary Clinton conspiracy theory, you wonder? Well, one Donald Trump supporter seems to think Hillary Clinton’s health issues may be because she is actually sick with AIDS. This Donald Trump supporter goes on to speculate that Bill Clinton gave his wife AIDS. The supporter also believed Magic Johnson had something to do with it. Did one (or both) of the Clintons have an intimate relationship with Magic Johnson? This Donald Trump supporter seems to think so!

Check out the video The Daily Show shared on Facebook below to see what other Hillary Clinton conspiracy theories the host of the Comedy Central television show was able to uncover:

According to The Political Insider, while the theory that the Clintons had an intimate relationship with Magic Johnson might be a bit of a stretch, there may actually be some merit to the Trump supporters’ theory that Hillary Clinton is sick with AIDS. Authors Darwin Porter and Danforth Prince released a new book titled Bill & Hillary: So This is That Thing Called Love. The book features interviews from sources close to the Clintons.

One of the sources reveal that Hillary repeatedly has Bill get HIV tests from doctors because of how many women he has been intimate with. The source goes on to reveal this is a decision Hillary made because her husband preferred to be intimate with all of these women without protection.

While the sources went on to reveal that the very first tests came back negative, there is no public information about the rest of the tests as both Hillary and Bill have done a pretty good job keeping their medical records and history out of the public eye. The Political Insider speculates that Bill Clinton having AIDS would explain the rapid change in his appearance, his heart surgery, his new diet, and the fact that he looks dramatically thin and weak at all of his wife’s campaign rallies.

The Political Insider goes on to point out that George W. Bush and Bill Clinton are roughly the same age, and while Bush continues to look healthy, Clinton continues to look older and frailer. Furthermore, it goes without saying that AIDS would also explain the recent bout of medical episodes and issues Hillary Clinton continues to suffer from as well.

Dick Morris, Bill Clinton’s former advisor, has even come forward to say Clinton isn’t looking too great these days and is hard to recognize as he looks washed out and appears to be having a hard time thinking or speaking.

Pink News reports former basketball star Earvin “Magic” Johnson, Jr. has been living with HIV since the year 1991. So, while it is a stretch, he could have had something to do with the Clintons getting AIDS – if they have AIDS.

It goes without saying that some of the questions the host of The Daily Show on Comedy Central asked the supporters at the Trump rally were intended to mock them for believing Hillary Clinton conspiracy theories. For example, the host admitted to printing out two identical pictures of Hillary Clinton before asking supporters if they looked different or which one was the body double.

Could there, however, be any merit to the conspiracy theory that Hillary Clinton has AIDS? Share your thoughts in the comments section.