The emergence of antiretroviral resistance mutations represents a major threat to the achievement of national and global goals for the elimination of HIV-1 infection. The global strategy in 2019 in Cte d'Ivoire is...The emergence of antiretroviral resistance mutations represents a major threat to the achievement of national and global goals for the elimination of HIV-1 infection. The global strategy in 2019 in Cte d'Ivoire is a new national policy for the management of people living with HIV with the administration of dolutegravir (DTG)-based fixed-dose combination. The aim of our study was to evaluate HIV-1 resistance to antiretrovirals (ARVs) in infected adult subjects in Cte d’Ivoire in the context of a systematic switch to a DTG-based combination. Between February 2022 and October 2023, a cross-sectional survey with random sampling was conducted in 06 services caring for people living with HIV. A total of 139 participants were included in the study. Adults with a viral load ≥ 1000 copies/mL were tested for HIV-1 ARV resistance mutations. Molecular analyses were performed using protocol of ANRS-MIE (National Agency for Research on AIDS and emerging infectious diseases). The interpretation is performed by HIVGRAD (https://www.hiv-grade.de/cms/grade/). The frequencies of HIV-1 resistance to non-nucleotide reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs), integrase inhibitors (IINTs) and protease inhibitors (PIs) were 82%, 73%, 19% and 11% respectively. The main mutations observed in the different classes were K103N (45%), M184V (64%), E157Q (19%) and L10V/M46I/A71V/I54V (6%) respectively. This study reveals the emergence of resistance to DTG-based fixed-dose combinations, favored by high rates of resistance to NRTIs and NNRTIs. This finding underlines the need for enhanced viral load monitoring and HIV-1 genotyping tests to guide the choice of NRTIs for combination therapy. In addition, monitoring for mutations to second-generation NRTIs is essential, given the scale-up of DTG-based regimens currently underway in Cte d’Ivoire.展开更多
Cryptosporidium spp. infection is one of the causes of diarrhea in people living with HIV/AIDS. The objective of this study is to compare the sensitivity of microscopy and molecular biology to determine the prevalence...Cryptosporidium spp. infection is one of the causes of diarrhea in people living with HIV/AIDS. The objective of this study is to compare the sensitivity of microscopy and molecular biology to determine the prevalence of Cryptosporidium spp. in Patients Living With HIV (PLWH). This is a descriptive cross-sectional study conducted in three care centers for people living with HIV/AIDS in Abidjan. It took place from November 2018 to March 2020. Sociodemographic data were obtained via a questionnaire. Stool and blood samples were collected and analyzed for microscopy and Nested PCR detection of Cryptosporidium spp. Blood samples were analyzed for CD4+ count. A total of 363 stool samples were collected from the three sites. Individuals aged 40 - 50 years (36.52%) were most likely to participate in the study. HIV Type 1 accounted for 86.22% of the study population. The samples collected consisted of 47.65% diarrheal stool. Microscopic examination of the stool yielded a prevalence of 3.86% for Cryptosporidium spp. while the prevalence was 3.96% with molecular identification. No statistically significant difference was observed between these two prevalences (χ<sup>2</sup> = 0.26;p = 0.609). CD4+ count was the factor associated with Cryptosporidium spp. infection for both microscopy (OR = 0.887, p = 0.001) and PCR (OR = 0.896, p = 0.001). This study demonstrated that Nested PCR improves the detection of Cryptosporidium spp. in patient diagnosis.展开更多
文摘The emergence of antiretroviral resistance mutations represents a major threat to the achievement of national and global goals for the elimination of HIV-1 infection. The global strategy in 2019 in Cte d'Ivoire is a new national policy for the management of people living with HIV with the administration of dolutegravir (DTG)-based fixed-dose combination. The aim of our study was to evaluate HIV-1 resistance to antiretrovirals (ARVs) in infected adult subjects in Cte d’Ivoire in the context of a systematic switch to a DTG-based combination. Between February 2022 and October 2023, a cross-sectional survey with random sampling was conducted in 06 services caring for people living with HIV. A total of 139 participants were included in the study. Adults with a viral load ≥ 1000 copies/mL were tested for HIV-1 ARV resistance mutations. Molecular analyses were performed using protocol of ANRS-MIE (National Agency for Research on AIDS and emerging infectious diseases). The interpretation is performed by HIVGRAD (https://www.hiv-grade.de/cms/grade/). The frequencies of HIV-1 resistance to non-nucleotide reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs), integrase inhibitors (IINTs) and protease inhibitors (PIs) were 82%, 73%, 19% and 11% respectively. The main mutations observed in the different classes were K103N (45%), M184V (64%), E157Q (19%) and L10V/M46I/A71V/I54V (6%) respectively. This study reveals the emergence of resistance to DTG-based fixed-dose combinations, favored by high rates of resistance to NRTIs and NNRTIs. This finding underlines the need for enhanced viral load monitoring and HIV-1 genotyping tests to guide the choice of NRTIs for combination therapy. In addition, monitoring for mutations to second-generation NRTIs is essential, given the scale-up of DTG-based regimens currently underway in Cte d’Ivoire.
文摘Cryptosporidium spp. infection is one of the causes of diarrhea in people living with HIV/AIDS. The objective of this study is to compare the sensitivity of microscopy and molecular biology to determine the prevalence of Cryptosporidium spp. in Patients Living With HIV (PLWH). This is a descriptive cross-sectional study conducted in three care centers for people living with HIV/AIDS in Abidjan. It took place from November 2018 to March 2020. Sociodemographic data were obtained via a questionnaire. Stool and blood samples were collected and analyzed for microscopy and Nested PCR detection of Cryptosporidium spp. Blood samples were analyzed for CD4+ count. A total of 363 stool samples were collected from the three sites. Individuals aged 40 - 50 years (36.52%) were most likely to participate in the study. HIV Type 1 accounted for 86.22% of the study population. The samples collected consisted of 47.65% diarrheal stool. Microscopic examination of the stool yielded a prevalence of 3.86% for Cryptosporidium spp. while the prevalence was 3.96% with molecular identification. No statistically significant difference was observed between these two prevalences (χ<sup>2</sup> = 0.26;p = 0.609). CD4+ count was the factor associated with Cryptosporidium spp. infection for both microscopy (OR = 0.887, p = 0.001) and PCR (OR = 0.896, p = 0.001). This study demonstrated that Nested PCR improves the detection of Cryptosporidium spp. in patient diagnosis.
