Human Immunodeficiency Virus and Hepatitis C Virus Co-infection in Cameroon: Investigation of the Genetic Diversity and Virulent Circulating Strains

Background: RNA virus infections represent a significant cause of illness and death in vertebrates. Specifically in humans, RNA viruses are responsible for a wide range of acute, chronic, emerging and re-emerging infections. HIV and HCV rank as some of the most severe RNA viruse infections facing Africa. Methods: To determine genotypes and subtypes of HIV and HCV among co-infected patients in Cameroon, viral RNA was isolated from HIV/HCV co-infected individuals, in Douala, Cameroon. A total of 36 HIV/HCV co-infected isolates (22 from volunteer blood donors and 14 from people living with HIV/AIDS not yet on antiretroviral treatment) were analyzed using molecular biology techniques that involved RT-PCR, gene/TOPO cloning, DNA sequencing, and bioinformatics tools for sequence management and analysis. Epidemiological data were examined as well.Results: Results show that HIV strains isolated belong to the circulating recombinant forms CRF02_AG, whereas HCV isolates from Cameroon belong to genotypes 1, 2, and 4. The corresponding HCV subtypes investigated were 1a, 1b, 1c, 2a, 2c, 2k, and 4a. Subtypes 1a and 1b, most frequently found in developed countries, also circulate in Cameroon. Epidemiologic data show that HIV/HCV co-infected patients are older than HIVmono-infected patients.Conclusions: These results indicate that HIV/HCV co-infection represent a significant threat in Cameroon. There is evidence of genetic diversity of HIV and HCV; virulent hepatitis C virus subtypes 1a and 1b circulate in Cameroon. An epidemiological and molecular database on HIV and HCV is necessary for the development of further intervention in Cameroon as an imperative for monitoring disease progression.Key words: HIV; HCV; Co-infection ; Genotypes ; Virulent

HIV Genetic Diversity in Cameroon: Possible Public Health Importance

To monitor the evolving molecular epidemiology and genetic diversity of HIV in a country where many distinct strains cocirculate, we performed genetic analyses on sequences from 75 HIV-1-infected Cameroonians: 74 were group M and 1 was group O. Of the group M sequences, 74 were classified into the following env gp41 subtypes or recombinant forms: CRF02 (n = 54), CRF09 (n = 2), CRF13 (n = 2), A (n = 5), CRF11 (n = 4), CRF06 (n = 1), G (n = 2), F2 (n = 2), and E (n = 1, CRF01), and 1 was a JG recombinant. Comparison of phylogenies for 70 matched gp41 and protease sequences showed inconsistent classifications for 18 (26%) strains. Our data show that recombination is rampant in Cameroon with recombinant viruses continuing to recombine, adding to the complexity of circulating HIV strains. This expanding genetic diversity raises public health concerns for the ability of diagnostic assays to detect these unique HIV mosaic variants and for the development of broadly effective HIV vaccines.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63150/1/aid.2006.22.812.pd

Targeting Antibody Responses to the Membrane Proximal External Region of the Envelope Glycoprotein of Human Immunodeficiency Virus

Although human immunodeficiency type 1 (HIV-1) infection induces strong antibody responses to the viral envelope glycoprotein (Env) only a few of these antibodies possess the capacity to neutralize a broad range of strains. The induction of such antibodies represents an important goal in the development of a preventive vaccine against the infection. Among the broadly neutralizing monoclonal antibodies discovered so far, three (2F5, Z13 and 4E10) target the short and hidden membrane proximal external region (MPER) of the gp41 transmembrane protein. Antibody responses to MPER are rarely observed in HIV-infected individuals or after immunization with Env immunogens. To initiate antibody responses to MPER in its membrane-embedded native conformation, we generated expression plasmids encoding the membrane-anchored ectodomain of gp41 with N-terminal deletions of various sizes. Following transfection of these plasmids, the MPER domains are displayed on the cell surface and incorporated into HIV virus like particles (VLP). Transfected cells displaying MPER mutants bound as efficiently to both 2F5 and 4E10 as cells transfected with a plasmid encoding full-length Env. Mice immunized with VLPs containing the MPER mutants produced MPER-specific antibodies, the levels of which could be increased by the trimerization of the displayed proteins as well as by a DNA prime-VLP boost immunization strategy. Although 2F5 competed for binding to MPER with antibodies in sera of some of the immunized mice, neutralizing activity could not be detected. Whether this is due to inefficient binding of the induced antibodies to MPER in the context of wild type Env or whether the overall MPER-specific antibody response induced by the MPER display mutants is too low to reveal neutralizing activity, remains to be determined

Feasibility of a randomized clinical trial evaluating a community intervention for household tuberculosis child contact management in Cameroon and Uganda

Background One of the main barriers of the management of household tuberculosis child contacts is the necessity for parents to bring healthy children to the facility. We assessed the feasibility of a community intervention for tuberculosis (TB) household child contact management and the conditions for its evaluation in a cluster randomized controlled trial in Cameroon and Uganda. Methods We assessed three dimensions of feasibility using a mixed method approach: (1) recruitment capability using retrospective aggregated data from facility registers; (2) acceptability of the intervention using focus group discussions with TB patients and in-depth interviews with healthcare providers and community leaders; and (3) adaptation, integration, and resources of the intervention in existing TB services using a survey and discussions with stakeholders. Results Reaching the sample size is feasible in all clusters in 15 months with the condition of regrouping 2 facilities in the same cluster in Uganda due to decentralization of TB services. Community health worker (CHW) selection and training and simplified tools for contact screening, tolerability, and adherence of preventive therapy were key elements for the implementation of the community intervention. Healthcare providers and patients found the intervention of child contact investigations and TB preventive treatment management in the household acceptable in both countries due to its benefits (competing priorities, transport cost) as compared to facility-based management. TB stigma was present, but not a barrier for the community intervention. Visit schedule and team conduct were identified as key facilitators for the intervention. Conclusions This study shows that evaluating a community intervention for TB child contact management in a cluster randomized trial is feasible in Cameroon and Uganda. Trial registration Clini calTr ials. gov NCT03832023. Registered on February 6th 2019

Profil De L’hemogramme Chez Les Donneurs De Sang A L’ouest Du Cameroun

Cette étude prospective a pour but d’étudier le profil de l’hémogrammechez les donneurs de sang prélevés dans deux banques de sang de l’Ouest du Cameroun afin de fournir aux autorités des arguments scientifiques valides permettant de compléter par l’hémogramme les critères biologiques d’aptitude au don de sang. Elle concerne 127 donneurs de sang (volontaires et familiaux) rencontrés lors des collectes de sang mobiles et fixes effectuées par l’Hôpital Régional de Bafoussam (HRB) et les Cliniques Universitaires des Montagnes (CUM) de Mai à Octobre 2013. L’hémogramme a été réalisé à l’aide d’un automate d’hématologie de type URIT-3000 Plus Hematology Analyze et l’analyse des données a été faite sur Microsoft Excel 2007. L’âge moyen des donneurs est de 31.32 ans et la proportion de donneurs bénévoles volontaires est de 30% contre 70% de donneurs familiaux. Dans notre série, 28% des donneurs sont anémiés et l’anémie est hypochrome microcytaire chez 55.6% de ces donneurs. Globalement, il y a une tendance à l’anémie chez certains donneurs réguliers de phénotypes rares à cause de la fréquente sollicitation aux dons et d’une absence de prise en charge de la déplétion martiale  occasionnée par une telle pratique. L’analyse de la lignée blanche montre une leucopénie chez 14.96% des donneurs et un cas d’hyperleucocytose a été observé. Quant à l’analyse des données sur les plaquettes on  remarque une thrombopénie chez 3.14% de donneurs et une  thrombocytose chez 8 donneurs de sang (soit 6.29% des cas). Cette étude recommande l’intérêt du dosage systématique de l’hémoglobine pré-don pouvant orienter certains donneurs anémiés vers des services spécialisés pour des examens complémentaires comme l’hémogramme en vue d’une prise en charge spécialisée. English Title:The Full Count Profile In Blood Donors In Two HospitalsIn The West Region Of CameroonThis prospective study aims to describe the blood count profile in blood donors collected from two blood banks in Western Cameroon in order to provide the authorities with valid scientific arguments to define the criteria for eligibility to blood donation. A total of 127 blood donors (volunteers and families) were included during the mobile and fixed blood collections carried out by the Bafoussam Regional Hospital (HRB) and the University Mountain Clinics (CUM) from May to October 2013. The blood count was performed using a Hematology Analyzer type URIT- 3000Plus Hematology Analyze and data analysis was done on Microsoft Excel 2007. The average donor’s age was 31.32 years and the proportion of volunteer donors was 30%. In our study, 28% of donors were anemic and anemia was microcytic hypochromic in 55.6% of case. Overall, there is a trend of anemia among some regular donors of rare phenotypes because of the frequent solicitation of donations and lack of iron replacement. The analysis of white cells showed leukopenia in 14.96% of donors and one case of leukocytosis was observed. As for platelet data analysis, thrombocytopenia was found in 3.14% of donors and thrombocytosis in 8 blood donors (6.29% of cases). We recommend a systematic hemoglobin screening prior to donation that will guide help to refer anemic donors to specialized services for additional analysis.Key Words: Blood donor, blood count, West CameroonMots clés: Donneurs de sang, hémogramme, Ouest Camerou