Short communication: Population-based surveillance of HIV-1 drug resistance in cameroonian adults initiating antiretroviral therapy according to the world health organization guidelines

Joseph Fokam, Désiré Takou, Maria Mercedes Santoro, Haniel Ze Akonie, Charles Kouanfack, Francesca Ceccherini-Silberstein, Vittorio Colizzi, Carlo Federico Perno, Alexis Ndjolo

Research output: Contribution to journalArticle

Abstract

With ongoing earlier enrollment on and rapid scale-up of antiretroviral therapy (ART) in Cameroon, there are increasing risks of transmitted HIV drug resistance (HIVDR) at population levels. We, therefore, evaluated the threshold of HIVDR in a population initiating ART, to inform on the effectiveness of first-line regimens, considering HIV-1 diversity, plasma viral load (PVL), and CD4-based disease progression. A total of 53 adults [median (interquartile range, IQR) CD4: 162 cell/mm3 (48-284); median (IQR) PVL: 5.34 log10 RNA (4.17-6.42) copies/ml] initiating ART in 2014 at the Yaoundé Central Hospital were enrolled for HIV-1 protease-reverse transcriptase sequencing. Drug resistance mutations (DRMs) were interpreted using the 2009 World Health Organization (WHO) list versus the Stanford HIVdb algorithm version 7.0. Level of DRMs was low (3.77%) versus moderate (7.55%), respectively, following the WHO list (T69D, K103N) versus Stanford HIVdb (T69D, A98G, K103N, K238T), respectively. Prevailing clade was CRF02-AG (71.70%). Based on Stanford HIVdb, a slightly higher proportion of patients with DRMs were found among ones infected with CRF02-AG than in those non-CRF02-AG infected (7.89% vs. 6.67%, p = 1.000), with lower PVL (7.69% 10 RNA copies/ml, p = .488) and with higher CD4 counts (9.52% CD4 ≥200 vs. 3.33% CD4 3, p = .749). Thresholds of DRMs suggest that standard first-line regimens currently used in Cameroon may remain effective at population levels, despite scale-up of ART in the country, pending adherence, and closed virological monitoring. With an intent-to-diagnose approach, the discrepant levels of DRMs support using Stanford HIVdb to evaluate initial ART, while revising the WHO list for surveillance.

Original languageEnglish
Pages (from-to)329-333
Number of pages5
JournalAIDS Research and Human Retroviruses
Volume32
Issue number4
DOIs
Publication statusPublished - Apr 1 2016

ASJC Scopus subject areas

  • Immunology
  • Virology
  • Infectious Diseases

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