Despite enormous efforts to achieve the goal of eliminating mother-to-child transmission of HIV-1, it remains a major challenge for many countries in sub-Saharan Africa, particularly Mali. Our objective is to assess c...Despite enormous efforts to achieve the goal of eliminating mother-to-child transmission of HIV-1, it remains a major challenge for many countries in sub-Saharan Africa, particularly Mali. Our objective is to assess changes in the rate of mother-to-child transmission of HIV-1. We conducted a cross-sectional study between January 1, 2009 to December 31, 2018 (10 years) of early diagnosis activity in newborns and children born to HIV-1-positive mothers at the National Institute for Public Health (INSP). The samples came from health and referral centers in mali. All samples were received at the Laboratory of Molecular Biology at the INSP. Proviral DNA extraction was performed from a blood spot sample with a Roche DNA kit, Cobas AmpliPrep/Cobas TaqMan HIV-1 qualitative Test, V2.0 (Roche Molecular System, Inc, USA) following the company procedures. Molecular diagnosis was performed using the same kits using an algorithm of three identical PCRs. The Epi Info version 7 software was used for data analysis with a significance threshold of 5%. A total of 10,714 samples of infants and children born to HIV-positive mothers were analyzed by PCR. Ninety-six percent of mothers were on ARV prophylaxis (AZT 3TC NVP and AZT NVP) and 60% of newborns received the same ARV prophylaxis. Of these children, 956 tested positive with an overall transmission rate of 8.92%, varying between 7.27% in 2009 and 08.01% in 2018. This rate was relatively low among children receiving prophylaxis at 2.04% and remained high for children who received breastfeeding at 5.62%. However, the transmission rate remains low for those who have benefited from mixed and artificial breastfeeding at 1.58% and 1.27% respectively. A significant proportion of children remained infected by their mothers during pregnancy, childbirth or breastfeeding. This study shows the importance of early diagnosis of HIV in children using molecular technology.展开更多
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
Introduction: HIV, the human immunodeficiency virus, is the etiological agent of acquired immunodeficiency syndrome (AIDS). The aim of this study was to assess the evolution of the viral load in patients under treatme...Introduction: HIV, the human immunodeficiency virus, is the etiological agent of acquired immunodeficiency syndrome (AIDS). The aim of this study was to assess the evolution of the viral load in patients under treatment. Methodology: This was a study carried out from July 2017 to June 2022 at the Point G University Hospital laboratory. The determination of the viral load of patients was carried out by PCR on the ABOTT M2000sp/rt platform. Results: A total of 129 patients infected with HIV-1, aged 19 to 72 years with a mean age of 40.05 years ± 10.71;all on antiretroviral chemotherapy. The female gender predominated among our patients. The most common treatment regimen was 2INTI + 1INNTI with 72.9% followed by 2INTI + 1INI with 13.2%. As for the combinations of molecules, the combination TDF + 3TC + EFV and TDF + 3TC + DTG predominated, respectively 65.1% and 13.2%. 89.9% of our patients had undetectable viremia after 12 months of treatment (p < 0.005) with an average viral load which had evolved from 681315.65 copies/ml ± 1616908.484 to M0 at 5742.36 copies /ml ± 35756.883 at M12 (p Conclusion: Generally speaking, antiretroviral treatment had contributed to controlling viral loads, however the therapeutic combination TDF + 3TC + DTG had made it possible to obtain more patients with undetectable viremia instead.展开更多
目的了解2011—2020年大连市无偿献血人群的HIV耐药性突变的分布和传播趋势。方法对2011—2020年大连市无偿献血者HIV感染标本的PR-RT序列进行检测,利用The Stanford HIV Drug Resistance Database分析标本耐药性突变和耐药程度。结果在...目的了解2011—2020年大连市无偿献血人群的HIV耐药性突变的分布和传播趋势。方法对2011—2020年大连市无偿献血者HIV感染标本的PR-RT序列进行检测,利用The Stanford HIV Drug Resistance Database分析标本耐药性突变和耐药程度。结果在174份标本中共检测出30份携带耐药性突变(drug resistance mutation,DRM),DRM携带率为17.2%(30/174),传播性耐药(transmitted drug resistance,TDR)携带率为5.7%(10/174)。研究期间,DRM和TDR携带率在2019年出现大幅度升高,2020年分别达到44.4%、22.2%,均为历史最高水平。具备大专以上学历、本地常住特征的献血者其DRM携带率显著高于其他人群(P<0.05)。标本携带NNRTI类DRM占比最高(12.6%,22/174),PI类次之(5.7%,10/174),分别以V179D/E/T和M46I为主;仅1份(0.57%,1/174)携带NRTI类DRM(L74I)。标本整体耐药率为6.9%(12/174),以对NNRTI类药物耐药占比最高(83.3%,10/12);2份(1.1%,2/174)标本同时对一线推荐用药EFV和NVP高度耐药。基因型为CRF55_01B标本的DRM携带率显著高于其他基因型(P<0.05)。结论2019—2020年大连市无偿献血人群HIV耐药性突变携带率呈现明显上升趋势,对NNRTI类药物耐药标本占比最高。将ART实施前后的耐药性监测数据与最新版国家ART治疗方案相结合,有利于提高本地HIV防控效果。展开更多
目的对保定市新发现的1株pol区不能明确分型的HIV-1毒株(BD226AJ)进行近似全长基因组扩增,并分析其亚型、重组模式和基因特点。方法提取患者血浆中HIV-1RNA并逆转录为cDNA,使用近末端稀释法分2段对其进行近似全长基因组扩增并测序。使用...目的对保定市新发现的1株pol区不能明确分型的HIV-1毒株(BD226AJ)进行近似全长基因组扩增,并分析其亚型、重组模式和基因特点。方法提取患者血浆中HIV-1RNA并逆转录为cDNA,使用近末端稀释法分2段对其进行近似全长基因组扩增并测序。使用jpHMM和SimPlot 3.5软件对近似全长基因组序列进行重组模式和重组断点分析,采用MEGA 6.0软件分片段构建Neighbor-joining系统进化树进一步确认重组断点的准确性。构建该近似全长基因组序列及各亚型片段Neighbor-joining系统进化树,分析该毒株的亲本来源。结果经过近似全长基因组扩增、测序、序列拼接后,获得1条长度为8830 bp的HIV-1近似全长基因组序列。重组分析结果显示,该序列是由CRF01_AE和B亚型重组形成的,其近似全长基因组序列被3个断点分成了4个亚型片段,分别为ICRF01_AE(HXB2,823—4224 nt)、Ⅱ_(B)(HXB2,4225—5991 nt)、ⅢCRF01_AE(HX B2,5992—9295 nt)、ⅣB(HXB2,9296—9406 nt)。各亚型基因片段的系统进化树分析进一步表明该序列的可能亲本来源为CRF01_AE和B亚型。HIV BLAST的结果显示,该序列与CRF112_01B的相似性为96%,系统进化树分析进一步验证该序列与北京市男男性行为者(men who have sex with men,MSM)中的CRF112_01B序列聚集。结论本研究在保定市MSM人群中发现了1例由CRF01_AE和B亚型重组的新型重组毒株CRF112_01B,提示HIV-1CRF112_01B已通过MSM人群传入河北,并开始在保定市传播,因此加强该亚型或者类似新型毒株的监测,对有关部门采取针对性防控措施和遏制新型重组毒株在本地区的传播和流行具有重要意义。展开更多
文摘Despite enormous efforts to achieve the goal of eliminating mother-to-child transmission of HIV-1, it remains a major challenge for many countries in sub-Saharan Africa, particularly Mali. Our objective is to assess changes in the rate of mother-to-child transmission of HIV-1. We conducted a cross-sectional study between January 1, 2009 to December 31, 2018 (10 years) of early diagnosis activity in newborns and children born to HIV-1-positive mothers at the National Institute for Public Health (INSP). The samples came from health and referral centers in mali. All samples were received at the Laboratory of Molecular Biology at the INSP. Proviral DNA extraction was performed from a blood spot sample with a Roche DNA kit, Cobas AmpliPrep/Cobas TaqMan HIV-1 qualitative Test, V2.0 (Roche Molecular System, Inc, USA) following the company procedures. Molecular diagnosis was performed using the same kits using an algorithm of three identical PCRs. The Epi Info version 7 software was used for data analysis with a significance threshold of 5%. A total of 10,714 samples of infants and children born to HIV-positive mothers were analyzed by PCR. Ninety-six percent of mothers were on ARV prophylaxis (AZT 3TC NVP and AZT NVP) and 60% of newborns received the same ARV prophylaxis. Of these children, 956 tested positive with an overall transmission rate of 8.92%, varying between 7.27% in 2009 and 08.01% in 2018. This rate was relatively low among children receiving prophylaxis at 2.04% and remained high for children who received breastfeeding at 5.62%. However, the transmission rate remains low for those who have benefited from mixed and artificial breastfeeding at 1.58% and 1.27% respectively. A significant proportion of children remained infected by their mothers during pregnancy, childbirth or breastfeeding. This study shows the importance of early diagnosis of HIV in children using molecular technology.
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Introduction: HIV, the human immunodeficiency virus, is the etiological agent of acquired immunodeficiency syndrome (AIDS). The aim of this study was to assess the evolution of the viral load in patients under treatment. Methodology: This was a study carried out from July 2017 to June 2022 at the Point G University Hospital laboratory. The determination of the viral load of patients was carried out by PCR on the ABOTT M2000sp/rt platform. Results: A total of 129 patients infected with HIV-1, aged 19 to 72 years with a mean age of 40.05 years ± 10.71;all on antiretroviral chemotherapy. The female gender predominated among our patients. The most common treatment regimen was 2INTI + 1INNTI with 72.9% followed by 2INTI + 1INI with 13.2%. As for the combinations of molecules, the combination TDF + 3TC + EFV and TDF + 3TC + DTG predominated, respectively 65.1% and 13.2%. 89.9% of our patients had undetectable viremia after 12 months of treatment (p < 0.005) with an average viral load which had evolved from 681315.65 copies/ml ± 1616908.484 to M0 at 5742.36 copies /ml ± 35756.883 at M12 (p Conclusion: Generally speaking, antiretroviral treatment had contributed to controlling viral loads, however the therapeutic combination TDF + 3TC + DTG had made it possible to obtain more patients with undetectable viremia instead.
文摘目的了解2011—2020年大连市无偿献血人群的HIV耐药性突变的分布和传播趋势。方法对2011—2020年大连市无偿献血者HIV感染标本的PR-RT序列进行检测,利用The Stanford HIV Drug Resistance Database分析标本耐药性突变和耐药程度。结果在174份标本中共检测出30份携带耐药性突变(drug resistance mutation,DRM),DRM携带率为17.2%(30/174),传播性耐药(transmitted drug resistance,TDR)携带率为5.7%(10/174)。研究期间,DRM和TDR携带率在2019年出现大幅度升高,2020年分别达到44.4%、22.2%,均为历史最高水平。具备大专以上学历、本地常住特征的献血者其DRM携带率显著高于其他人群(P<0.05)。标本携带NNRTI类DRM占比最高(12.6%,22/174),PI类次之(5.7%,10/174),分别以V179D/E/T和M46I为主;仅1份(0.57%,1/174)携带NRTI类DRM(L74I)。标本整体耐药率为6.9%(12/174),以对NNRTI类药物耐药占比最高(83.3%,10/12);2份(1.1%,2/174)标本同时对一线推荐用药EFV和NVP高度耐药。基因型为CRF55_01B标本的DRM携带率显著高于其他基因型(P<0.05)。结论2019—2020年大连市无偿献血人群HIV耐药性突变携带率呈现明显上升趋势,对NNRTI类药物耐药标本占比最高。将ART实施前后的耐药性监测数据与最新版国家ART治疗方案相结合,有利于提高本地HIV防控效果。
文摘目的对保定市新发现的1株pol区不能明确分型的HIV-1毒株(BD226AJ)进行近似全长基因组扩增,并分析其亚型、重组模式和基因特点。方法提取患者血浆中HIV-1RNA并逆转录为cDNA,使用近末端稀释法分2段对其进行近似全长基因组扩增并测序。使用jpHMM和SimPlot 3.5软件对近似全长基因组序列进行重组模式和重组断点分析,采用MEGA 6.0软件分片段构建Neighbor-joining系统进化树进一步确认重组断点的准确性。构建该近似全长基因组序列及各亚型片段Neighbor-joining系统进化树,分析该毒株的亲本来源。结果经过近似全长基因组扩增、测序、序列拼接后,获得1条长度为8830 bp的HIV-1近似全长基因组序列。重组分析结果显示,该序列是由CRF01_AE和B亚型重组形成的,其近似全长基因组序列被3个断点分成了4个亚型片段,分别为ICRF01_AE(HXB2,823—4224 nt)、Ⅱ_(B)(HXB2,4225—5991 nt)、ⅢCRF01_AE(HX B2,5992—9295 nt)、ⅣB(HXB2,9296—9406 nt)。各亚型基因片段的系统进化树分析进一步表明该序列的可能亲本来源为CRF01_AE和B亚型。HIV BLAST的结果显示,该序列与CRF112_01B的相似性为96%,系统进化树分析进一步验证该序列与北京市男男性行为者(men who have sex with men,MSM)中的CRF112_01B序列聚集。结论本研究在保定市MSM人群中发现了1例由CRF01_AE和B亚型重组的新型重组毒株CRF112_01B,提示HIV-1CRF112_01B已通过MSM人群传入河北,并开始在保定市传播,因此加强该亚型或者类似新型毒株的监测,对有关部门采取针对性防控措施和遏制新型重组毒株在本地区的传播和流行具有重要意义。
