title: HIV-1 group O infection in Cameroon from 2006 to 2013: Prevalence, genetic diversity, evolution and public health challenges.
abstract: The human immunodeficiency virus, HIV, is characterized by a tremendously high genetic diversity, leading to the currently known circulating HIV types, groups, subtypes, and recombinant forms. HIV-1 group O is one of the most diverse forms of HIV-1 and has been so far related to Cameroon or individuals originating from Cameroon. In this study, we investigated in Cameroon, the evolution of this viral group from 2006 to 2013, in terms of prevalence, genetic diversity and public health implications. Our results confirmed the predominance of HIV-1 group M (98.5%), a very low prevalence (<0.02%) for HIV-1 group N and P, and HIV-2 in this country. HIV-1 group O was found at around 0.6% (95% confidence interval: 0.4-0.8%), indicating that the frequency of this virus in Cameroon has remained stable over the last decades. However, we found an extensive high genetic diversity within this HIV-1 group, that resulted from previous steady increase on the effective number of HIV-1 group O infections through time, and the current distribution of the circulating viral strains still does not allow classification as subtypes. The frequency of dual infections with HIV-1 group M and group O was 0.8% (95% confidence interval: 0.6-1.0%), but we found no recombinant forms in co-infected patients. Natural resistance to integrase inhibitors was not identified, although we found several mutations considered as natural polymorphisms. Our study shows that infections with HIV-1 group O can be adequately managed in countries where the virus circulates, but this complex virus still represents a challenge for diagnostics and monitoring strategies.
authors.affiliation: Unité Mixte International 233, Institut de Recherche pour le Développement, INSERM U1175, and University of Montpellier, Montpellier, France; Computational Biology Institute, Montpellier, France. Electronic address: christian-julian.villabona-arenas@univ-montp1.fr.
authors.forename: Christian Julian
authors.initials: CJ
authors.lastname: Villabona-Arenas
authors.affiliation: Centre de Recherche sur les Maladies Emergentes et Réémergentes - CREMER, Laboratoire de Virologie IMPM-IRD, Yaoundé, Cameroon. Electronic address: jdomyem@yahoo.fr.
authors.forename: Jenny
authors.initials: J
authors.lastname: Domyeum
authors.affiliation: Unité Mixte International 233, Institut de Recherche pour le Développement, INSERM U1175, and University of Montpellier, Montpellier, France. Electronic address: fatima.mouacha@ird.fr.
authors.forename: Fatima
authors.initials: F
authors.lastname: Mouacha
authors.affiliation: Unité Mixte International 233, Institut de Recherche pour le Développement, INSERM U1175, and University of Montpellier, Montpellier, France. Electronic address: christelle.butel@ird.fr.
authors.forename: Christelle
authors.initials: C
authors.lastname: Butel
authors.affiliation: Unité Mixte International 233, Institut de Recherche pour le Développement, INSERM U1175, and University of Montpellier, Montpellier, France. Electronic address: Eric.Delaporte@ird.fr.
authors.forename: Eric
authors.initials: E
authors.lastname: Delaporte
authors.affiliation: Unité Mixte International 233, Institut de Recherche pour le Développement, INSERM U1175, and University of Montpellier, Montpellier, France. Electronic address: martine.peeters@ird.fr.
authors.forename: Martine
authors.initials: M
authors.lastname: Peeters
authors.affiliation: Centre de Recherche sur les Maladies Emergentes et Réémergentes - CREMER, Laboratoire de Virologie IMPM-IRD, Yaoundé, Cameroon. Electronic address: empoudi2001@yahoo.co.uk.
authors.forename: Eitel
authors.initials: E
authors.lastname: Mpoudi-Ngole
authors.affiliation: Unité Mixte International 233, Institut de Recherche pour le Développement, INSERM U1175, and University of Montpellier, Montpellier, France; Centre de Recherche sur les Maladies Emergentes et Réémergentes - CREMER, Laboratoire de Virologie IMPM-IRD, Yaoundé, Cameroon. Electronic address: avelin.aghokeng@ird.fr.
authors.forename: Avelin Fobang
authors.initials: AF
authors.lastname: Aghokeng
mesh_terms: D002163:Cameroon / Q000453:epidemiology; D019143:Evolution, Molecular; D014644:Genetic Variation; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D015233:Models, Statistical; D015995:Prevalence; D011634:Public Health; D012189:Retrospective Studies
keywords: Cameroon; Dual infections; Genetic diversity; HIV-1 group O; Prevalence; Resistance