APOBEC3G Role on HIV Infection in Africa: A Systematic Review

The highly active antiretroviral treatment (HAART) has allowed people living with HIV to live longer with a better quality of life. However, toxicity and the emergence of drug resistance arise from HAART use. Therefore, new antiretroviral therapy is needed since no cure or vaccine is available against HIV. Virus-host interaction has been proven to be important in the last decade. Host factors such as the C-C chemokine receptor type 5 (CCR5), a receptor used by HIV to penetrate host cells, have led to the discovery of the Maraviroc, which is an antiretroviral medication used in the United States. In contrast, other factors like C-X-C Motif Chemokine Receptor 4 (CXCR4) and the Apolipoprotein B mRNA editing enzyme catalytic polypeptide-like 3G (APOBEC3G), a potent host defense factor against HIV, is under investigation. APOBEC3G antiviral activity remains a possible therapeutic target against HIV. This systematic review aimed to synthesize the available evidence on the role of APOBEC3G polymorphisms and their expression on HIV infection disease progression in Africa. We used Web of Science, PubMed, Embase, and Google Scholar and searched for relevant publications in French or English reporting on APOBEC3G polymorphisms association with HIV infection in African populations from January 2009 to May 2023. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyzes) was used to process for reporting systematic review. Fifteen studies were included, of which seven were on APOBEC3G polymorphisms and eight were on APOBEC3G expression. Among the APOBEC3G polymorphisms, the most studied was H186R or rs8177832. The average of the minor allele frequency of H186R of APOBEC3G available for the studies included in this study was 0.29 with a 95% CI (0.172;0.401) and varied from 0.108 reported in Uganda to 0.47 recorded from Burkina Faso. The polymorphism H186R was not associated with HIV status in Southern Africa. However, the referent allele of H186R was protective against HIV infection in Western Central Africa, while in West Africa, it was the minor allele (G) of H186R which was protective against HIV. This review warrants a need to increase research on APOBEC3G, from its variants to its hypermutations on the continent with an essential variety of HIV-1 subtypes, to impact the research on A3G-based anti-HIV strategies.

DC-SIGN (CD209) Promoter -336 A/G Polymorphism Is Not Associated with Dengue Fever at Burkina Faso, West Africa

Objective: The aim of this study was to characterize the polymorphisms of the DC-SIGN (-336 A/G, rs4804803) gene and their association with the immunopathogenicity of dengue fever in Burkina Faso. Methods: A total of three hundred forty-one subjects, patients of all ages have been included in the study: 208 persons presenting clinical signs of dengue fever which were confirmed by diagnostic and 133 Healthy Controls. Genotyping for the CD209 variant (-336 A/G, rs4804803) was carried out using TaqMan SNP Genotyping Assays. Haplotype frequencies were inferred and compared between the study groups. Results: The percentage of men was 61.88% (211/341) and 38.12% (130/341) for women. The highest frequency of dengue fever (77.42%) was noted in patients with age between 20 to 40 years. Around 1.52% of the study population was positive for HIV, 40.55% were carriers of HBV and 3.83% of HCV. Genotype distribution of the CD209 variant (-336 A/G, rs4804803) was in Hardy-Weinberg equilibrium in both patients and controls. The frequency of allele A was higher than allele G;however, statistical analyses showed that there is no significant difference in genotypes GG, AG and AA in patients and controls. Conclusion: This related no significant association with dengue for the variant of ?336 A/G in the DC-SIGN gene in an Ouagadougou population. However, our results offered the SNP frequencies in a West African population, which might be useful for the study of ethnic groups.

Relationship between the Polymorphism of the GSTP1 (rs1695) Gene and Chronic Hepatitis B Infection in Ouagadougou, Burkina Faso

Introduction: Genetic polymorphisms of some Glutathione S-Transferase (GST) which encode the enzyme responsible for the biotransformation of drugs and xenobiotics, have been associated with the risk of several pathologies that can progress to cancer such as Hepatitis B. This study aims to characterize the impact of the rs1695 polymorphism of GSTP1 gene among people with chronic Hepatitis B infection in Burkina Faso. Methods: rs1695 polymorphisms of GSTP1 gene genotyping was performed for 50 people infected with chronic Hepatitis B virus and 124 healthy people with the PCR-RFLP method. Conventional PCR was used for DNA amplification and Alw26I enzyme was used for enzymatic digestion. Results: The results show that the frequencies of AA, AG and GG genotypes are respectively 31.00%, 36.80% and 32.20% in general the study population with a mutation rate of 50.57%. However, the incidence of the AA, AG and GG genotypes are respectively 30.64%, 38.71% and 30.64% among people with chronic Hepatitis B virus infection and 32.00%, 32.00% and 36.00% among healthy people. In cases, the frequencies of the A and G alleles are 48.00% and 52.00% respectively, and in controls 50.00% each. No statistical difference was found by comparing genotypic and allelic frequencies between cases and controls (p > 0.05). Conclusion: Our study allowed us to determine the rate of GSTP1 rs1695 genotypes in the study population, cases and controls. From our analyses, GSTP1 rs1695 is not associated to chronic Hepatitis B virus infection in Ouagadougou.

Helicobacter pylori Virulence Genes cagA, babA2, and vacA Detection in Dyspeptic Patients from Burkina Faso

The diverse clinical presentation of Helicobacter pylori (H. pylori) infection results from the interaction between bacterial virulence, host genetics, socio-demographic and environmental factors. This study aimed to characterize Helicobacter pylori virulence genes and the associated behavioral factors among dyspeptic patients in Burkina Faso. Two hundred and fifty (250) stool samples were collected from patients with dyspepsia seen at health centers in Ouagadougou, Burkina Faso. Bacterial deoxyribonucleic acid (DNA) was extracted using a commercial kit. Virulence genes were detected using conventional multiplex Polymerase Chain Reaction with specific primers. The overall prevalence of Helicobacter pylori of the 250 participants was 91.20%. CagA virulence gene was present among 20.19% of individuals, while babA2 and vacA were detected respectively among 9.65% and 67.54% of the population positive for Helicobacter pylori. Among vacA subtypes, vacAs1 was the most frequent, with 39.04%, followed by vacAi1 (19.74%), vacAi2 (17.54%), and vacAs2 with 10.96%. Regarding vacAm1 and vacAm2, they were less frequent at 6.14% each. “Handwashing three times or less per day” significantly increased the risk of having vacAi2 allele and H. pylori rRNA16s, with p-values of 0.013 and 0.020, respectively. The consumption of non-tap water increases the risk of carrying the cagA virulence gene. Additionally, H. pylori-positive patients living with more than four (4) people in their household had about two times the risk of having the vacAs1 allele. The present study shows the detection of Helicobacter pylori cagA, vacA subtypes, and babA2 by stool a PCR method in Burkina Faso. The strong association between sanitary habits and virulence factors depicts the composite interaction between ecological factors, gastric mucosa, and bacteria. Therefore, the synergic action of these factors should be considered when aiming for bacterial eradication and gastric pathology cure.

Involvement of CD40 (rs1883832) and MAP3K14 (rs2074292) Genes Polymorphisms in Hepatitis B Virus Infection in Burkina Faso, West Africa

Introduction: Hepatic diseases comprise inflammations of the liver, which can originate from drug-induced, toxic, autoimmune sources and particularly hepatitis B and C virus infection. The outcome of the disease is linked to interactions between the immune system and the virus, and also depends on the age and immune status of the patient. The aim of this study was to evaluate the association of a MAP3K14 (rs2074292), CD40 (rs1883832) polymorphism and chronic hepatitis B virus carriage in a population from Burkina Faso. Methods: In this case-control analysis, 223 and 173 samples, consisting of 90 and 53 controls and 133 and 120 cases, were examined for MAP3K14 and CD40 respectively. The cases included patients with Chronic Hepatitis B (CHB), cirrhosis or hepatocellular carcinoma (HCC). Genomic DNA extraction was executed using INVITROGEN and FAVORGEN kits. Genotyping of MAP3K14 (rs2074292) and CD40 (rs1883832) gene polymorphisms was accomplished via real-time PCR on the QuantStudioTM 5 Real-Time instrument, followed by allelic discrimination using TaqMan Genotyper Software. Data was interpreted using SPSS version 20 and Epi info version 7.5.2.0. Odds ratios (OR), confidence intervals (CI), and p-values were derived for risk and significance evaluation. Results: This study showed that the heterozygous CT genotype and the mutated T allele of the CD40 (rs1883832) gene are involved in the progression of chronic hepatitis to cirrhosis and hepatocellular carcinoma in HBV-infected patients. However, no association was found between polymorphisms in the MAP3K14 gene (rs2074292) and the progression of HBV infection. By combining the two polymorphisms, we observed either high risk or protection, depending on the genotypes of the MAP3K14 and CD40 genes simultaneously carried by the patient. Conclusion: Polymorphisms of the MAP3K14 and CD40 genes are associated with the evolution of HBV infection.

Hepatitis B and C Immunological and Molecular Parameter Analysis in HIV-Positive Patients Undergoing Antiretroviral Therapy at Saint Camille Hospital in Ouagadougou (HOSCO), Burkina Faso

Knowledge of the clinical and biological profile of patients infected with HIV and hepatitis B and/or C is essential in order to identify and implement effective management strategies. Methods: This was a retrospective descriptive study from January 01, 2016 to June 01, 2021. Adult patients aged at least 18 years infected with HIV type 1 and/or 2, na?ve to ARV treatment. Univariate analyses were assessed using Pearson’s Chi2 test. The Student Newman test was used for comparison between groups using R software version 4.0.2. Objective: To draw up the epidemiological, clinical, paraclinical and evolutionary profiles of HIV-treated-patients in relation to HIV/HBV and HIV/HCV co-infections in order to allow the identification and the implementation of effective management strategies. Results: Of the 379 patients included 280 (73.88%) were women. At treatment initiation, the mean age was 40.14 ± 11.84 years. The majority of patients consulted at WHO stage III (51.45%). Clinical suspicion was the most frequent screening circumstance (51.71%). The pathologies frequently reported at the first consultation were diarrhea (28%) and shingles (16%). Body mass index was normal in 50.5% of patients. HIV1 infection was the majority (91.03%). A total of 270 had a CD4 count at treatment initiation. The mean CD4 cell count was 304.17 ± 242.06 cells/μL, and 116 (42.59%) of them had a CD4 ≤ 200 cells/μL. Viral load at treatment initiation was documented in 62 patients (16.35%) and 70.97% of them had a detectable viral load (greater than 1000 copies/mL). The clinical and biological evolution was relatively good in patients after therapeutic initiation. HIV-HBV co-infection was 24.11% and HIV-HCV co-infection was 2.26%. The mortality rate was 3.69%. Conclusion: These results reflect a significant delay in HIV infection diagnosis. Furthermore, hepatitis B and/or C is co-infections that increasingly affect people living with HIV. It also appears that COVID 19 disease has had a strong impact on patient management. Thus, new screening strategies must be implemented to encourage early diagnosis of HIV, hepatitis B and C. Effective strategies are also necessary to fight HIV in the context of epidemics and/or pandemics.

Risk Factors Associated with Mother-to-Child Transmission of HIV-1, Spontaneous Abortion and Infant Mortality in HIV-1 Infected Women in Burkina Faso: A Prospective Study

Background: Despite efforts to fight, HIV/AIDS mother-to-child transmission of HIV-1 (MTCT), as well as abortion and infant mortality, remains a problem in sub-Saharan Africa. Indeed, a low level of CD4 and a high viral load can be associated with these situations. The aim of this study was to determine the risk factors associated with the occurrence of MTCT, spontaneous abortion and infant mortality in HIV-1 infected women in Ouagadougou, Burkina Faso. This was a prospective study conducted from May 2014 to September 2017 and involved 423 HIV-1 infected women followed at Saint Camille Hospital in Ouagadougou, Burkina Faso. Sociodemographic data were collected through a questionnaire. The CD4 count and HIV-1 viral load were determined using respectively BD FACSCount and Abbott m2000rt instruments. Bivariate analysis and multinomial logistic regression were performed for associations with a significance threshold for p Results: The average age of women was 38.75 ± 7.98 years. Rates of MTCT, abortion and infant mortality were 16.31%, 30.49% and 34.75%, respectively. The number of pregnancies was associated with the number of infant deaths (p = 0.002). A correlation between the number of pregnancies and infant mortality was observed (p = 0.002) with a relatively high rate (28.6%) among women who had three pregnancies. In addition, marital status was associated with HIV-1 infection in infants (p = 0.042) and spontaneous abortion (p = 0.033). HIV-1 infected women with low CD4 counts (less than 350 cells/μL) and those with viral load more than 1000 copies/mL were about twice as likely to have an spontaneous abortion [OR (IC 95%): 2.50 (1.085 - 5.760);p = 0.03] and [OR (95% CI): 2.16 (1.043 - 4.505);p = 0.04]. Conclusions: The results of this study show the need to improve the treatment of HIV-1 infected women in order to restore CD4 levels and make viral load of HIV-1 undetectable.

Lumbar Hernia, a Rare Cause of Intestinal Occlusion: About a Case

Defects of the posterolateral abdominal wall of the abdomen, lumbar hernias are rare. They represent 2% to 3% of hernias of the abdominal wall. This rarity explains the large number of short series and the absence of a well-defined therapeutic modality in the publications. Grynfeltt’s hernia at the top and Jean Louis Petit’s at the bottom are the two entities. The old lumbar hernias are bulky with a rich history and easy diagnosis. Though young, they are discreet and reveal most often by their strangulation. We report the case of a Grynfeltt hernia revealed by colonic occlusion in a 77-year-old woman who had a superior right posteriolateral tumefaction for 15 years. The hernia cure was prosthetic made by the sandwich technique. No recurrence was observed after 25 months of follow-up. Through a review of the literature, we reveal the diagnostic and therapeutic difficulties.

Rotavirus, Norovirus and Astrovirus in Children Aged 0 - 5 Years: Evolution of Prevalence over 10 Years (2013-2023) Following the Introduction of Rotavirus Vaccines in Burkina Faso

Rotaviruses, noroviruses, and astroviruses are responsible for gastroenteritis in children under 5 years old. The objective of our study was to estimate the evolution of prevalence of rotavirus, norovirus and astrovirus infections in children aged 0 to 5 years with gastroenteritis, after the introduction of rotavirus vaccines in Burkina Faso. This cross-sectional study was conducted between January and December 2023, collecting 100 stool samples from children with gastroenteritis at Saint Camille Hospital in Ouagadougou and the Charles De Gaulle University Paediatric Hospital. Noroviruses and astroviruses were detected using multiplex real-time PCR with a Sacace biotechnology detection kit. Data analysis was performed with Stata statistical software, version 16.0. The prevalence of norovirus infections was 14% and astrovirus infections were 9%. Rotavirus infections were found at prevalence of 15%. The age group most affected by norovirus and astrovirus infections was 0 - 12 months, with respective prevalence rates of 73.34% and 55.56%. The most frequently observed clinical signs in children infected with astrovirus were fever (77.78%), diarrhea (55.56%), and vomiting (44.44%). The introduction of rotavirus vaccines has reduced rotavirus-related infections. However, this has not significantly impacted the prevalence of norovirus and astrovirus infections in Burkina Faso.