Herbert A Mbunkah1,2,3, Alex Marzel1,2, Stefan Schmutz2, Yik Lim Kok1,2, Osvaldo Zagordi2, Mohaned Shilaih1, Ndi N Nsanwe4, Eyongetah T Mbu4, Lydia M Besong5, Bella A Sama6, Emmanuel Orock7, Roger D Kouyos1,2, Huldrych F Günthard1,2, Karin J Metzner1,2. 1. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland. 2. Institute of Medical Virology, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland. 3. Life Science Zurich Graduate School, Microbiology and Immunology PhD Programme, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland. 4. Regional Hospital Bamenda, PO Box 863, Mankon-Bamenda, Cameroon. 5. District Hospital Kumba, Meme Division, South-West Region, Cameroon. 6. District Hospital Ndop, Ngoketunjia Division, North-West Region, Cameroon. 7. Regional Hospital Ngaoundere, Avenue Rue Ahidjo Ngaoundéré, Adamawa, Cameroon.
Abstract
Objectives: To determine the most recent prevalence, transmission patterns and risk factors of transmitted drug-resistance mutations (TDRMs) in Cameroon, we initiated a multicentre study monitoring HIV-1 drug resistance in newly HIV-1-diagnosed individuals using a novel next-generation sequencing (NGS) assay applicable to fingerprick dried blood spot (DBS) samples. Methods: Fingerprick DBS samples and questionnaires were collected from 360 newly HIV-1-diagnosed individuals in four hospitals in urban areas in Cameroon in the years 2015-16. We developed an HIV-1 protease and reverse transcriptase drug resistance genotyping assay applicable to DBS samples and HIV-1 genomes of groups M, N and O. The WHO 2009 list of mutations for surveillance of transmitted drug-resistant HIV strains was used to analyse TDRMs. Results: Applying our 'DBS-NGS-genotypic resistance test', baseline HIV-1 drug resistance data were successfully obtained from 82.8% (298/360) of newly diagnosed individuals. At nucleotide frequencies >15%, TDRMs to NRTIs were observed in 3.0% (9/298), to NNRTIs in 4.0% (12/298) and to PIs in 1.3% (3/240). The NNRTI mutation K103N was most commonly detected (2.7%). Expanding the analysis to low-abundance TDRMs, i.e. 3%-15%, 12 additional individuals (4.0%) harbouring TDRMs were identified. Having unprotected sex with a known HIV-1-positive person was significantly associated with the transmission of DRMs (adjusted OR 9.6; 95% CI 1.79-51.3). Conclusions: The prevalence of transmitted HIV-1 drug resistance is currently low in the study sites in Cameroon. Evidence of some risky sexual behaviours depicts a public health problem with possible implications for the prevention of new HIV-1 infections.
Objectives: To determine the most recent prevalence, transmission patterns and risk factors of transmitted drug-resistance mutations (TDRMs) in Cameroon, we initiated a multicentre study monitoring HIV-1 drug resistance in newly HIV-1-diagnosed individuals using a novel next-generation sequencing (NGS) assay applicable to fingerprick dried blood spot (DBS) samples. Methods: Fingerprick DBS samples and questionnaires were collected from 360 newly HIV-1-diagnosed individuals in four hospitals in urban areas in Cameroon in the years 2015-16. We developed an HIV-1 protease and reverse transcriptase drug resistance genotyping assay applicable to DBS samples and HIV-1 genomes of groups M, N and O. The WHO 2009 list of mutations for surveillance of transmitted drug-resistant HIV strains was used to analyse TDRMs. Results: Applying our 'DBS-NGS-genotypic resistance test', baseline HIV-1 drug resistance data were successfully obtained from 82.8% (298/360) of newly diagnosed individuals. At nucleotide frequencies >15%, TDRMs to NRTIs were observed in 3.0% (9/298), to NNRTIs in 4.0% (12/298) and to PIs in 1.3% (3/240). The NNRTI mutation K103N was most commonly detected (2.7%). Expanding the analysis to low-abundance TDRMs, i.e. 3%-15%, 12 additional individuals (4.0%) harbouring TDRMs were identified. Having unprotected sex with a known HIV-1-positive person was significantly associated with the transmission of DRMs (adjusted OR 9.6; 95% CI 1.79-51.3). Conclusions: The prevalence of transmitted HIV-1 drug resistance is currently low in the study sites in Cameroon. Evidence of some risky sexual behaviours depicts a public health problem with possible implications for the prevention of new HIV-1 infections.
Authors: Herbert A Mbunkah; Silvia Bertagnolio; Raph L Hamers; Gillian Hunt; Seth Inzaule; Tobias F Rinke De Wit; Roger Paredes; Neil T Parkin; Michael R Jordan; Karin J Metzner Journal: J Infect Dis Date: 2020-04-27 Impact factor: 5.226
Authors: Santiago Ávila-Ríos; Neil Parkin; Ronald Swanstrom; Roger Paredes; Robert Shafer; Hezhao Ji; Rami Kantor Journal: Viruses Date: 2020-06-05 Impact factor: 5.048
Authors: Jennifer A Brown; Herbert A Mbunkah; Thabo I Lejone; Isaac Ringera; Molisana Cheleboi; Thomas Klimkait; Karin J Metzner; Huldrych F Günthard; Niklaus D Labhardt; Roger D Kouyos; Nadine Tschumi Journal: Open Forum Infect Dis Date: 2021-02-02 Impact factor: 3.835