Commercial Logging and HIV Epidemic, Rural Equatorial Africa

We found a high seroprevalence of HIV among young women in a commercial logging area in Cameroon. The vulnerability of these young women could be related to commercial logging and the social and economic networks it induces. The environmental changes related to this industry in Equatorial Africa may facilitate HIV dissemination

Antiretroviral Drug Resistance and Routine Therapy, Cameroon

Among 128 patients routinely receiving highly active antiretroviral therapy in an HIV/AIDS outpatient clinic in Cameroon, 16.4% had drug resistance after a median of 10 months. Of these, 12.5% had resistance to nucleoside reverse transcriptase inhibitors (NRTIs), 10.2% to non-NRTIs, and 2.3% to protease inhibitors

Hepatotoxicity and effectiveness of a Nevirapine-based antiretroviral therapy in HIV-infected patients with or without viral hepatitis B or C infection in Cameroon

Background: Coinfection with hepatitis B virus (HBV) or hepatitis C virus (HCV) in HIV-infected patients receiving a commonly used nevirapine-based antiretroviral therapy is a major concern for African clinicians owing to its high prevalence, the infrequent testing and treatment of viral hepatitis, and the impact of liver disease on the tolerability and effectiveness of anti-HIV treatment. We compared the hepatotoxicity and the immunological, virological and clinical effectiveness of a nevirapine-based antiretroviral therapy between patients infected with HIV only and patients coinfected with hepatitis B or C virus in Cameroon. Methods: A retrospective cohort study was conducted among HIV-1-infected patients. Plasma HBV DNA and HCV RNA were tested in positive or indeterminate samples for HBsAg or HCV antibodies, respectively. All patients received nevirapine and lamivudine plus stavudine or zidovudine. Results: Of 169 HIV-1-infected patients with a median baseline CD4 count of 135 cells/mm(3) (interquartile range [IQR] 67 218), 21% were coinfected with HBV or HCV. In coinfected patients, the median viral load was 2.47 x 107 IU/mL for HBV (IQR 3680-1.59 x 10(8)) and 928 000 IU/mL for HCV (IQR 178 400-2.06 x 10(6)). Multivariate analyses showed that the risk of hepatotoxicity was 2-fold higher in coinfected patients (p < 0.01). The response to antiretroviral therapy was however comparable between monoinfected and coinfected patients in terms of CD4 cell count increase (p = 0.8), HIV-1 viral load below 400 copies/mL (p = 0.9), death (p = 0.3) and death or new AIDS-defining event (p = 0.1). Nevirapine was replaced by a protease inhibitor in 4 patients owing to hepatotoxicity. Conclusion: This study suggests that the nevirapine-based antiretroviral therapy could be used safely as first-line treatment in patients with low CD4 cell count in Africa despite frequent coinfections with HBV or HCV and infrequent testing of these infections. Although testing for HBV and HCV should be systematically performed before initiating antiretroviral therapy, transaminases elevations at baseline or during treatment should be a decisive argument for testing when hepatitis status is unknown

Vaccination des voyageurs à destination des zones tropicales (Étude des connaissances et des pratiques des médecins généralistes de l'Hérault en 2012)

Le médecin généraliste représente souvent le premier recours du voyageur pour des conseils avant le départ. Les objectifs de cette étude étaient d'évaluer l'adéquation des vaccinations et des conseils de prévention, fournis par les médecins généralistes aux voyageurs à destination des zones tropicales, par rapport aux reconunandations françaises, et d'identifier leurs sources d'infonnation. METHODE 431 médecins généralistes installés dans l'Hérault ont été tirés au sort. Un questiolUlaire anonyme a été adressé aux 369 médecins ayant accepté de participer à l'enquête. Ils devaient notanunent indiquer les vaccinations et la chimioprophylaxie antipaludique qu'ils préconisaient face à 2 situations cliniques (séjour en Thaïlande et au Sénégal). RESULTATS 211 questionnaires ont été reçus. 55% des médecins estimaient voir moins de 15 personnes/an pour des conseils avant un voyage, et 34 % d'entre eux, entre 15 et 30/an. Seuls 21% des médecins estimaient avoir reçu une bonne formation initiale et 49% d'entre eux jugeaient leurs connaissances insuffisantes dans ce domaine. Les sources d'information les plus utilisées étaient l expérience personnelle (76%), les sites internet (73%) et l'appel dans un centre de vaccination (71 %). Un schéma vaccinal adéquat était préconisé par 18% et 6% des médecins respectivement pour les deux situations cliniques et une chimioprophylaxie antipaludique adéquate était recommandée respectivement par 62% et 70% d'entre eux. CONCLUSION Internet semble être le moyen d'information le plus adapté. Une formation sur les outils qui existent actuellement, pourrait permettre aux médecins généralistes de sélectionner les sites pertinents donnant un accès à des informations de qualité et réactualisées régulièrement.MONTPELLIER-BU Médecine UPM (341722108) / SudocSudocFranceF

Cloud Detection with Historical Geostationary Satellite Sensors for Climate Applications

Can we build stable Climate Data Records (CDRs) spanning several satellite generations? This study outlines how the ClOud Fractional Cover dataset from METeosat First and Second Generation (COMET) of the EUMETSAT Satellite Application Facility on Climate Monitoring (CM SAF) was created for the 25-year period 1991&#8722;2015. Modern multi-spectral cloud detection algorithms cannot be used for historical Geostationary (GEO) sensors due to their limited spectral resolution. We document the innovation needed to create a retrieval algorithm from scratch to provide the required accuracy and stability over several decades. It builds on inter-calibrated radiances now available for historical GEO sensors. It uses spatio-temporal information and a robust clear-sky retrieval. The real strength of GEO observations&#8212;the diurnal cycle of reflectance and brightness temperature&#8212;is fully exploited instead of just accounting for single &#8220;imagery&#8221;. The commonly-used naive Bayesian classifier is extended with covariance information of cloud state and variability. The resulting cloud fractional cover CDR has a bias of 1% Mean Bias Error (MBE), a precision of 7% bias-corrected Root-Mean-Squared-Error (bcRMSE) for monthly means, and a decadal stability of 1%. Our experience can serve as motivation for CDR developers to explore novel concepts to exploit historical sensor data

Characterization of a Highly Replicative Intergroup M/O Human Immunodeficiency Virus Type 1 Recombinant Isolated from a Cameroonian Patient

A Cameroonian patient with antibodies reacting simultaneously to human immunodeficiency virus type 1 (HIV-1) group O- and group M-specific V3-loop peptides was identified. In order to confirm that this patient was coinfected with both viruses, PCRs with O- and M-specific discriminating primers corresponding to different regions of the genome were carried out with both primary lymphocyte DNA and the corresponding viral strains isolated from three consecutive patient samples. The PCR data suggested that this patient is coinfected with a group M virus and a recombinant M/O virus. Indeed, only type M gag sequences could be amplified, while for the env region, both type M and O sequences were amplified, from plasma or from DNA extracted from primary lymphocytes. Sequence analysis of a complete recombinant genome isolated from the second sample (97CA-MP645 virus isolate) revealed two intergroup breakpoints, one in the vpr gene and the second in the long terminal repeat region around the TATA box. Comparison of the type M sequences shared by the group M and the recombinant M/O viruses showed that these sequences were closely related, with only 3% genetic distance, suggesting that the M virus was one of the parental viruses. In this report we describe for the first time a recombination event in vivo between viruses belonging to two different groups, leading to a replicative virus. Recombination between strains with such distant lineages (65% overall homology) may contribute substantially to the emergence of new HIV-1 variants. We documented that this virus replicates well and became predominant in vitro. At this time, group O viruses represent a minority of the strains responsible for the HIV-1 pandemic. If such recombinant intergroup viruses gained better fitness, inducing changes in their biological properties compared to the parental group O virus, the prevalences of group O sequences could increase rapidly. This will have important implications for diagnosis of HIV-1 infections by serological and molecular tests, as well as for antiviral treatment

Prevalence of intestinal parasites including microsporidia in human immunodeficiency virus-infected adults in Cameroon: A cross-sectional study

To assess the prevalence of intestinal parasites in a cohort of human immunodeficiency virus (HIV)infected adults in Cameroon, a cross-sectional study was conducted. Detection of parasites was performed in 181 stool samples from 154 HIV-infected patients with a mean CD4 cell count of 238 cells/mm(3). Only 35 patients (22%) were receiving antiretroviral therapy at the time of stool sampling, and 46 (29%) had diarrhea. Opportunistic protozoa were found in 15 patients (9.7%), 8 of whom (53%) had diarrhea. Enterocytozoon bieneusi was found in eight patients, C parvum in six patients, and Isospora belli in three patients. All E. bieneusi isolates tested belonged to the same genotype. The prevalence of opportunistic protozoa among patients with CD4 cell counts less than 50/mm(3) was 32%