Facteurs influençant l’initiation au traitement antirétroviral des personnes vivant avec le VIH dans les Centres de Traitement Agréés de Bamenda et de Bertoua au Cameroun

Introduction: : L'objectif de ce travail était de déterminer les facteurs influençant l'initiation au  traitement antirétroviral des personnes vivant avec le VIH (PVVIH) dans les centres de traitements  agrées (CTA) de Bamenda et de Bertoua au Cameroun. Méthodes: Il s'agissait d'une étude transversale, analytique réalisée de Janvier à Avril 2011, dans les CTA de Bamenda et de Bertoua. Pour cette étude, nous avons obtenu une clairance éthique.Résultats: Nous avons étudiés 460 dossiers de patients séropositifs en phase d'initiation au traitement antirétroviral dans lesCTA de Bamenda et de Bertoua, 53,9% et 46,1% respectivement. L 'âge médian   était de 36 ans. La plupart des séropositifs à Bertoua (41) avaient fait un dépistage volontaire du VIH par rapport à ceux de Bamenda (22) (p= 0.008). Il y 'avait plus de VIH de type 1 et 2 dans le CTA de Bamenda (15) par rapport à Bertoua (3) (p= 0.011). La majorité des patients était classé au stade clinique II à Bamenda (54,0%) tandis qu 'à Bertoua le stade clinique III était prédominant (52,4%) (p=0,000). Le  taux médian de CD4 était de 133 cellules/mm3 dans le CTA de Bamenda et de 175 cellules/mm3 à Bertoua (p=0,008). La Zidovudine était plus prescrit à Bamenda et le Ténofovir à Bertoua (p=0,000). L 'Efavirenz était plus prescrit à Bertoua tandis que la Névirapine l 'était plus à Bamenda (p=0,000). Le Lopinavir/r était plus prescrit à  Bamenda qu 'à Bertoua (p=0,017).Conclusion: Il apparait urgent de standardiser la prise en charge des PVVIH dans les CTA du Cameroun.Key words: VIH, Personnes vivant avec le VIH, Traitement antirétroviral, Bamenda, Bertoua; Centre de traitement agrée, Cameroun

Hosting ICASA 2021 in South Africa amidst the global Omicron scare.

The 21 International Conference on HIV/AIDS and STI's in Africa (ICASA) was successfully held from the 6 to 11 December 2021 in Durban, South Africa. Little did we know at the time of planning that COVID-19 could become such a formidable force in eroding the progress made to bring lifesaving therapies among vulnerable communities in Africa. The conference also highlighted Africa's openness to the world, also shown in the way South Africa shared data on its discovery of the Omicron variant. Arguably the most important of lessons is that integrated HIV/TB services have become a platform on which to provide other services. We also saw how HIV and TB services were used as leverage for COVID-19 services. Much was also discussed about the need to adopt more self-care approaches, as was demonstrated with the increased use of self-testing technologies for HIV, and potentially other health needs. It's clear that Africa needs to increase its capacity to support and enable innovation, particularly in the design and manufacturing of new technologies including diagnostics, vaccines and therapeutics

African voices and leadership is imperative for the global AIDS response

CITATION: Mbopi-Keou, F. et al. 2019. African voices and leadership is imperative for the global AIDS response. Pan African Medical Journal, 32. doi:10.11604/pamj.2019.32.87.18452The original publication is available at https://www.panafrican-med-journal.com/This position paper is written in reference to the recent extensive media coverage of the report of the Independent Panel describing Harassment, Including Sexual Harassment, Bullying and Abuse of Power at UNAIDS Secretariat by several newspapers and authoritative journals such as Science and The Lancet. Unfortunately, none of these publications provide any clear evidence to support the accusations and merely repeat what are, in our view, unsubstantiated statements made in the report. Given the critical role that Africans have played in dealing with one of the most severe epidemics that the world has seen and the gravity of these charges, we believe it is essential to reaffirm that African voices and leadership is imperative for the global AIDS response.https://panafrican-med-journal.com/content/article/32/87/full/Publisher’s versio

African voices and leadership is imperative for the global AIDS response

This position paper is written in reference to the recent extensive media coverage of the report of the Independent Panel describing Harassment, Including Sexual Harassment, Bullying and Abuse of Power at UNAIDS Secretariat by several newspapers and authoritative journals such as Science and The Lancet. Unfortunately, none of these publications provide any clear evidence to support the accusations and merely repeat what are, in our view, unsubstantiated statements made in the report. Given the critical role that Africans have played in dealing with one of the most severe epidemics that the world has seen and the gravity of these charges, we believe it is essential to reaffirm that African voices and leadership is imperative for the global AIDS response

Evaluation des performances du cytomètre « MUSE AUTO CD4/CD4% » vs « GUAVA AUTO CD4/CD4% » pour la mesure du taux de lymphocytes CD4 chez des patients infectés par le VIH au Cameroun

Introduction: nous avons évalué les performances du cytomètre MUSE®, par rapport au cytomètre de référence GUAVA®. Méthodes: une étude expérimentale a été réalisée sur des échantillons de patients séropositifs au VIH. Les échantillons de sang veineux recueillis dans un tube K3 EDTA, ont été analysés dans un délai de 24-48h par les cytomètres MUSE® et GUAVA®, au Centre International de Diagnostic médical de Yaoundé. Résultats: au total, 227 échantillons ont été analysés. Il y avait une forte corrélation intraclasse (p<0,0001) entre les cytomètres MUSE® et GUAVA® avec un coefficient de 0,998 (95% IC: 0,998-0,999) pour les valeurs absolues et de 0,992 (95% IC: 0,989-0,994) pour les pourcentages. Une forte corrélation linéaire positive (p=0,000) a été retrouvée entre les cytomètres MUSE® et GUAVA® avec des pentes r2=0,98 (95% IC=0,97-0,99) pour les valeurs absolues et r2= 0,98 (95% IC= 0,96-1,00) pour les pourcentages. Les biais étaient de -4,80 cells/µl (-101,31-91,71) pour les valeurs absolues et de -0,89% (IC: -6,08-4,3) pour les pourcentages. Le pourcentage des points de données en dehors des limites d'accord était de 12/227 (5,29%) et de 10/227 (4,41%) respectivement pour les valeurs absolues et les pourcentages. Le coefficient Kappa de Cohen était de 0,92 et l'aire sous la courbe de 0,9975 (IC 95%: 0,99-1). Conclusion: le cytomètre MUSE®AUTO CD4/CD4% est un appareil performant car ses résultats concordent avec ceux donnés par le cytomètre de référence, et peut de fait permettre le suivi des patients infectés par le VIH notamment dans les pays en développement

Rates of HBV, HCV, HDV and HIV type 1 among pregnant women and HIV type 1 drug resistance-associated mutations in breastfeeding women on antiretroviral therapy

Abstract Background HBV, HCV, HDV and HIV are blood borne and can be transmitted from mother-to-child. Reports of HBV infection rates show up to 11.9% in Cameroon while for HCV, the rate is less than 2%. More so, as pregnant women get enrolled in the HIV PMTCT Programme and stay in the care continuum, selection of HIV-1 drug resistant strains is evident. We sought to determine the seroprevalence of HBV, HCV, HDV and HIV among pregnant women, assess their knowledge, attitudes and practices on transmission and prevention of HBV infection, and determine HIV drug resistance profile of breastfeeding women. Methods A serosurvey of HBV, HCV, HDV and HIV was carried out among 1005 pregnant women in Yaounde, Cameroon. In 40 HIV-infected breastfeeding women enrolled in the PMTCT Programme, HIV-1 genotypes and HIV-1 resistance to NRTIs, NNRTIs and PIs, were determined by phylogeny and the Stanford University HIV Drug Resistance interpretation tool, respectively. Results Among the pregnant women, the rates of HIV-1, HBV, HCV and HDV infections were 8.5, 6.4, 0.8 and 4.0%, respectively. About 5.9% of the women knew their HBV status before pregnancy unlike 63.7% who knew their HIV status. Although 83.3% reported that vaccination against HBV infection is a method of prevention, and 47.1% knew that HBV could be transmitted from mother-to-child, only 2.5% had received the Hepatitis B vaccine. Of the 40 women on antiretroviral therapy (ART), 9 had at least one major resistance-associated mutation (RAM, 22.5%) to NRTI, NNRTI or PI. Of these M184 V (12.5%), K70R (10.0%), K103 N (12.5%), Y181C (10.0%), M46 L (2.5%) and L90 M (2.5%) were most frequently identified, suggesting resistance to lamivudine, nevirapine, efavirenz and zidovudine. Eighty four percent were infected with HIV-1 recombinant strains with CRF02_AG predominating (50%). Conclusions The rates of HBV and HIV-1 infections point to the need for early diagnosis of these viruses during pregnancy and referral to care services in order to minimize the risk of MTCT. Furthermore, our results would be useful for evaluating the HIV PMTCT Programme and Treatment Guidelines for Cameroon