Diagnosis and monitoring of HIV-1 group O-infected patients in Cameroun.
OBJECTIVE
To define a routine algorithm for the specific diagnosis and complete follow-up of HIV-1 group O (HIV-O) infections in Cameroun.


METHODS
During 18 months, samples referred to Centre Pasteur du Cameroun for HIV testing or viral monitoring were screened for HIV-O infection with an in-house serotyping assay. HIV-O viral load was quantified by real-time polymerase chain reaction in the LTR gene and resistance genotyping was performed on pol and env sequences.


RESULTS
Of the 7030 samples tested, 78 HIV-O infections (1.1%) were identified, including 7 M and O dually seroreactive samples (9%). All treatment-naive patients and 59% of the patients receiving HAART had detectable viral loads. Analysis of pol sequences from 15 treatment-naive patients revealed a high number of polymorphisms in the protease region, with natural residues implicated in genotypic resistance to tipranavir and saquinavir for HIV-1 group M according to the Agence Nationale de Recherches sur le Sida et les Hépatites virales algorithm. Six patients (40%) harbored the 181C mutation conferring natural resistance to nonnucleoside reverse transcriptase inhibitors. Among antiretroviral-treated patients, major resistance mutations described for HIV-1 group M were found.


CONCLUSIONS
HIV-O prevalence remains relatively low in Cameroun. The cocirculation of groups M and O in this country leads to replicative dual infections. HIV-O-infected patients in this region can now benefit from effective and specific tools for a complete monitoring of infection. However, further studies are needed to understand long-term response to antiretrovirals of these complex variants.
Vessière
Aurélia
A
Centre Pasteur du Cameroun, Yaoundé, Cameroun.
Rousset
Dominique
D
Kfutwah
Anfumbom
A
Leoz
Marie
M
Depatureaux
Agnès
A
Simon
François
F
Plantier
Jean-Christophe
JC
D000465:Algorithms; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D024882:Drug Resistance, Viral / Q000187:drug effects; D015752:Genes, env / Q000235:genetics; D015751:Genes, pol / Q000235:genetics; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D015497:HIV-1 / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D009154:Mutation / Q000235:genetics; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011725:Pyridines / Q000627:therapeutic use; D011753:Pyrones / Q000627:therapeutic use; D019258:Saquinavir / Q000627:therapeutic use; D013449:Sulfonamides; D019562:Viral Load
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D011725:Pyridines; D011753:Pyrones; D013449:Sulfonamides; D019258:Saquinavir; C107201:tipranavir