HIV-1 drug mutations in children from northern Tanzania

Objectives: In resource-limited settings, it is a challenge to get quality clinical specimens due to poor infrastructure for their collection, transportation, processing and storage. Using dried blood spots (DBS) might be an alternative to plasma for HIV-1 drug resistance testing in this setting. The objectives of this study were to determine mutations associated with antiretroviral resistance among children 400 copies/mL. Results: Genotypic resistance mutations were detected in 13 of 46 children (28%). HIV-1 genotypes were A1 (n = 27), C (n = 10), A/D (n = 4), D (n = 3) and CRF10_CD (n = 2). The median age was 12 weeks (IQR 6–28). The mean log10 viral load was 3.87 copies/mL (SD 0.995). All major mutations were detected in the reverse transcriptase gene and none in the protease gene region. The most frequent mutations were Y181C (n = 8) and K103N (n = 4), conferring resistance to non-nucleoside reverse transcriptase inhibitors. Conclusions: One-third of infants newly diagnosed with HIV in northern Tanzania harboured major drug resistance mutations to currently used antiretroviral regimens. These mutations were detected from DBS collected from the field and stored at room temperature. Surveillance of drug resistance among this population in resource-limited settings is warranted

HIV-1 drug mutations in children from northern Tanzania

Objectives: In resource-limited settings, it is a challenge to get quality clinical specimens due to poor infrastructure for their collection, transportation, processing and storage. Using dried blood spots (DBS) might be an alternative to plasma for HIV-1 drug resistance testing in this setting. The objectives of this study were to determine mutations associated with antiretroviral resistance among children 400 copies/mL. Results: Genotypic resistance mutations were detected in 13 of 46 children (28%). HIV-1 genotypes were A1 (n = 27), C (n = 10), A/D (n = 4), D (n = 3) and CRF10_CD (n = 2). The median age was 12 weeks (IQR 6–28). The mean log10 viral load was 3.87 copies/mL (SD 0.995). All major mutations were detected in the reverse transcriptase gene and none in the protease gene region. The most frequent mutations were Y181C (n = 8) and K103N (n = 4), conferring resistance to non-nucleoside reverse transcriptase inhibitors. Conclusions: One-third of infants newly diagnosed with HIV in northern Tanzania harboured major drug resistance mutations to currently used antiretroviral regimens. These mutations were detected from DBS collected from the field and stored at room temperature. Surveillance of drug resistance among this population in resource-limited settings is warranted

HIV-1 Subtypes and treatment outcome among adults on Antiretroviral therapy at tertiary hospital in Moshi, Tanzania

Background: Human Immunodeficiency virus (HIV) is characterized by great genetic diversity due to its high mutations that occur during replication. Its infection also characterized by high rates of viral turnover and extensive viral diversity. This diverse has implication on disease progression, diagnostic strategies, vaccine development as well as treatment response to antiretroviral drugs.Methods: 63 HIV positive adults infected by different HIV-1 Subtypes at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania were studied. HIV-1 Subtypes were characterized using peptide ELISA representing HIV-1 subtypes A, B, C, D and E derived from consensus gp 120 V3 sequences. The CD4+T-lymphocyte cell counts were measured at baseline, six and twelve months using FACS Calliber (Becton Dickinson, San Jose, CA, USA).Results: HIV-1 Subtype A was the most prevalent (47.62%), followed by Subtype C (36.51%) and Subtype D (15.87%). Subtype D showed higher immunological and clinical failures as compared to subtype A and C with Hazard Ratio (H.R, 5.6) and 95% CI=1.3-5.2, P=0.02). After adjustment for sex, baseline CD4+ T Lymphocyte and clinical stage, the association remained the same.Conclusions: HIV-1 A was the most predominant followed by C and D was less predominant. HIV-1 D showed rapid progression of diseases with poor treatment outcomes relative to others subtypes. Keywords: HIV-1 diversity, immunological failure, ELISA, Peptides and immunodominant regio

Epidemiological study of Rift Valley fever virus in Kigoma, Tanzania

Rift Valley fever virus (RVFV) is an acute, zoonotic viral disease caused by a  Phlebovirus, which belongs to the Bunyaviridae family. Among livestock, outbreaks of the disease are economically devastating. They are often characterised by large, sweeping abortion storms and have significant mortality in adult livestock. The aim of the current study was to investigate RVFV infection in the Kigoma region, which is nestled under the hills of the western arm of the Great Rift Valley on the edge of Lake Tanganyika, Tanzania. A region-wide serosurvey was conducted on non-vaccinated small ruminants (sheep and goats, n = 411). Sera samples were tested for the presence of anti-RVFV antibodies and viral antigen, using commercial enzyme-linked immunosorbent assay and reverse transcriptase polymerase chain reaction, respectively. The overall past infections were detected in 22 of the 411 animals, 5.4% (Confidence Interval (CI) 95% = 3.5% – 8.1%). The Kigoma rural area recorded the higher seroprevalence of 12.0% (CI 95% = 7.3% – 18.3%; p 0.05) and the Kasulu district at 0.8% (CI 95% = 0.0% – 4.2%; p > 0.05). The prevalence was 12.5% and 4.7% for sheep and goats, respectively. Reverse transcriptase polymerase chain reaction results indicated that only eight samples were found to be positive (n = 63). This study has confirmed, for the first time, the presence of the RVFV in the Kigoma region four years after the 2007 epizootic in Tanzania. The study further suggests that the virus activity exists during the inter-epizootic period, even in regions with no history of RVFV