HIV-1 subtype diversity and immuno-virological outcomes among adolescents failing antiretroviral therapy in Cameroon: A cohort study.

Autor: Togna Pabo WLR; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.; Faculty of Science, University of Buea, Buea, Cameroon., Fokam J; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.; Faculty of Health Sciences, University of Buea, Buea, Cameroon.; National HIV Drug Resistance Group, Ministry of Public Health, Yaoundé, Cameroon., Njume D; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.; Faculty of Health Sciences, University of Buea, Buea, Cameroon., Takou D; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon., Santoro MM; University of Rome Tor Vergata, Rome, Italy., Nyasa RB; Faculty of Science, University of Buea, Buea, Cameroon., Chenwi C; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon., Mpouel ML; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon., Beloumou G; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon., Jagni ESN; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; University of Rome Tor Vergata, Rome, Italy.; Evangelic University of Cameroon, Bandjoun, Cameroon., Nka AD; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; University of Rome Tor Vergata, Rome, Italy.; Evangelic University of Cameroon, Bandjoun, Cameroon., Ka'e AC; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; University of Rome Tor Vergata, Rome, Italy., Teto G; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon., Dambaya B; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon., Djupsa S; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon., Gouissi Anguechia DH; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon., Evariste M; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon., Kamta C; Mfou District Hospital, Mfou, Cameroon., Bala L; Mbalmayo District Hospital, Mbalmayo, Cameroon., Lambo V; Nkomo Integrated Health Center, Nkomo, Cameroon., Halle-Ekane EG; Faculty of Health Sciences, University of Buea, Buea, Cameroon., Colizzi V; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; University of Rome Tor Vergata, Rome, Italy.; Evangelic University of Cameroon, Bandjoun, Cameroon., Perno CF; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; University of Rome Tor Vergata, Rome, Italy.; Bambino Gesu Pediatric Hospital, Rome, Italy., Ndjolo A; Chantal BIYA International Reference Centre for Research on HIV/AIDS prevention and management, Yaoundé, Cameroon.; Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon., Ndip Ndip R; Faculty of Science, University of Buea, Buea, Cameroon.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Oct 25; Vol. 18 (10), pp. e0293326. Date of Electronic Publication: 2023 Oct 25 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0293326
Abstrakt: Objective: We sought to evaluate the variability of HIV-1 and its effect on immuno-virological response among adolescents living with perinatally acquired HIV (APHI).
Methods: A cohort study was conducted from 2018-2020 among 311 APHI receiving antiretroviral therapy (ART) in Cameroon. Sequencing of protease and reverse transcriptase regions was performed for participants experiencing virological failure, VF, (Plasma viral load, PVL ≥ 1000 RNA copies/ml). HIV-1 subtypes were inferred by phylogeny; immuno-virological responses were monitored at 3-time points (T1-T3). Cox regression modeling was used to estimate adjusted hazard ratios (aHRs) of progression to: CD4 < 250, and PVL > 5log10, adjusted for acquired drug resistance, gender, ART line, adherence, and duration on treatment; p < 0.05 was considered statistically significant.
Results: Of the 141 participants in VF enrolled, the male-female ratio was 1:1; mean age was 15 (±3) years; and median [IQR] duration on ART was 51 [46-60] months. In all phases, 17 viral clades were found with a predominant CRF02_AG (58.2%, 59.4%, and 58.3%). From T1-T3 respectively, there was an increasing CD4 count (213 [154-313], 366 [309-469], and 438 [364-569] cells/mm3) and decline log10 PVL (5.23, 4.43, and 4.43), similar across subtypes. Among participants with CRF02_AG infection, duration of treatment was significantly associated with both rates of progression to CD4 < 250, and PVL > 5log10, aHR = 0.02 (0.001-0.52), and aHR = 0.05 (0.01-0.47) respectively. Moreover, four potential new HIV-1 recombinants were identified (CRF02_AG/02D, CRF02_AG/02A1F2, D/CRF02_AG, and AF2/CRF02_AG), indicating a wide viral diversity.
Conclusion: Among APHI in settings like Cameroon, there is a wide genetic diversity of HIV-1, driven by CRF02_AG and with potential novel clades due to ongoing recombination events. Duration of treatment significantly reduces the risk of disease progression.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Togna Pabo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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