Pre-Treatment HIV Drug Resistance and Genetic Diversity in Cameroon: Implications for First-Line Regimens.

Autor: Fokam J; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon.; Faculty of Health Science, University of Buea, Buea P.O. Box 0063, Cameroon.; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon.; National HIV Drug Resistance Prevention and Surveillance Working Group, Ministry of Public Health, Yaoundé P.O. Box 3038, Cameroon., Chenwi CA; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon.; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon.; Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome 'Tor Vergata', Via Montpellier 1, 00133 Rome, Italy., Tala V; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon.; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon., Takou D; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon., Santoro MM; Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome 'Tor Vergata', Via Montpellier 1, 00133 Rome, Italy., Teto G; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon., Dambaya B; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon., Anubodem F; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon.; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon., Semengue ENJ; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon.; Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome 'Tor Vergata', Via Montpellier 1, 00133 Rome, Italy.; Faculty of Sciences and Technologies, Evangelical University of Cameroon, Bandjoun P.O. Box 0127, Cameroon., Beloumou G; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon., Djupsa S; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon., Assomo E; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon., Fokunang C; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon., Alteri C; Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milano, Italy., Billong S; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon.; National HIV Drug Resistance Prevention and Surveillance Working Group, Ministry of Public Health, Yaoundé P.O. Box 3038, Cameroon., Bouba NP; Department of Disease, Epidemic and Pandemic Control, Ministry of Public Health, Yaounde P.O. Box 3038, Cameroon., Ajeh R; Central Technical Group, National AIDS Control Committee, Yaoundé P.O. Box 2005, Cameroon., Colizzi V; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon.; Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome 'Tor Vergata', Via Montpellier 1, 00133 Rome, Italy.; Faculty of Sciences and Technologies, Evangelical University of Cameroon, Bandjoun P.O. Box 0127, Cameroon., Mbanya D; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon.; National Blood Transfusion Service, Ministry of Public Health, Yaoundé P.O. Box 3038, Cameroon.; Haematology and Transfusion Service, Centre Hospitalier et Universitaire (CHU), Yaoundé P.O. Box 30335, Cameroon., Ceccherini-Silberstein F; Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome 'Tor Vergata', Via Montpellier 1, 00133 Rome, Italy., Perno CF; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon.; Bambino Gesu' Children's Research Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy., Ndjolo A; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Messa, Yaoundé P.O. Box 3077, Cameroon.; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon.
Jazyk: angličtina
Zdroj: Viruses [Viruses] 2023 Jun 28; Vol. 15 (7). Date of Electronic Publication: 2023 Jun 28.
DOI: 10.3390/v15071458
Abstrakt: The efficacy of first-line antiretroviral therapy (ART) may be hampered by the presence of HIV drug resistance (HIVDR). We described HIV-1 pre-treatment drug resistance (PDR) patterns, effect of viral clades on PDR, and programmatic implications on first-line regimens in Cameroon. A sentinel surveillance of PDR was conducted from 2014 to 2019. Sequencing of HIV-1 protease and reverse transcriptase was performed, and HIVDR was interpreted using Stanford HIVdb.v.9.4. In total, 379 sequences were obtained from participants (62% female, mean age 36 ± 10 years). The overall PDR rate was 15.0% [95% CI: 11.8-19.0] nationwide, with significant disparity between regions ( p = 0.03). NNRTI PDR was highest (12.4%), of which 7.9% had DRMs to EFV/NVP. Two regions had EFV/NVP PDR above the 10% critical threshold, namely the Far North (15%) and East (10.9%). Eighteen viral strains were identified, predominated by CRF02_AG (65.4%), with no influence of genetic diversity PDR occurrence. TDF-3TC-DTG predictive efficacy was superior (98.4%) to TDF-3TC-EFV (92%), p < 0.0001. The overall high rate of PDR in Cameroon, not substantially affected by the wide HIV-1 genetic diversity, underscores the poor efficacy of EFV/NVP-based first-line ART nationwide, with major implications in two regions of the country. This supports the need for a rapid transition to NNRTI-sparing regimens, with TDF-3TC-DTG having optimal efficacy at the programmatic level.
Databáze: MEDLINE
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