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Objectives: To evaluate the frequency and progression over time of the WHO-defined transmitted HIV-1 drug resistance mutations (DRMs) among antiretroviral treatment (ART)-naive HIV-1-infected patients in Cameroon. Design: We analyzed HIV-1 DRM data generated from 369 ART-naive individuals consecutively recruited between 1996 and 2007 in urban and rural areas in Cameroon. Methods: HIV-1 drug resistance genotyping was performed in the pol gene using plasma samples and surveillance DRMs were identified using the 2009 WHO-DRM list. Results: We observed in Yaounde, the capital city, an increasing prevalence of DRMs over time: 0.0% (none of 61 participants) in 1996-1999; 1.9% (one of 53 participants) in 2001; 4.1% (two of 49 participants) in 2002; and 12.3% (10 of 81 participants) in 2007. In the rural areas with more recently implemented ART programs, we found DRMs in six of 125 (4.8%) ART-naive individuals recruited in 2006-2007. DRMs identified in both areas included resistance mutations to protease inhibitors, nucleoside reverse transcriptase inhibitors (NRTIs) and non-NRTIs (NNRTIs) that might impair the efficacy of available first-line and second-line treatments. Conclusion: This report showed an increase in transmitted DRMs in areas where antiretroviral drugs were introduced earlier, although other factors such as natural viral polymorphisms and acquired DRMs through exposure to antiretroviral cannot be totally excluded. Further surveillances are needed to confirm this evolution and inform public health policies on adequate actions to help limit the selection and transmission of drug-resistant HIV, while scaling up access to ART in developing countries.

The complex molecule of the title compound, [Rh2{N(C6H5)COCH3}4(C8H7N)2], exhibits inversion symmetry. The four acetamidate ligands bridging the dirhodium core are arranged in a 2,2-transmanner with two N atoms and two O atoms coordinating to each RhIIatomtransto one another. The Neq—Rh—Rh—Oeqtorsion angles on the acetamidate bridge vary between −4.07 (5) and −6.78 (7)°. The axial nitrile ligands complete the distorted octahedral coordination sphere of each RhIIatom and show a nonlinear coordination with Rh—N—C bond angles of 151.6 (3) and 152.5 (3)°. The bond lengths of the two nitrile triple bonds are 1.133 (5) and 1.137 (5) Å.

In the title compound, [Rh2(C8H8NO)4(C8H7N)], the four acetamidate ligands bridging the dirhodium core are arranged in a 2,2-trans manner. One RhII atom is five-coordinate, in a distorted pyramidal geometry, while the other is six-coordinate, with a disorted octahedral geometry. For the six-coordinate RhII atom, the axial nitrile ligand shows a non-linear Rh–nitrile coordination with an Rh—N—C bond angle of 166.4 (4)° and a nitrile N—C bond length of 1.138 (6) Å. Each unique RhII atom is coordinated by a trans pair of N atoms and a trans pair of O atoms from the four acetamide ligands. The Neq—Rh—Rh—Oeq torsion angles on the acetamide bridge varies between 12.55 (11) and 14.04 (8)°. In the crystal, the 3-methylbenzonitrile ring shows a π–π interaction with an inversion-related equivalent [interplanar spacing = 3.360 (6) Å]. A phenyl ring on one of the acetamide ligands also has a face-to-face π–π interaction with an inversion-related equivalent [interplanar spacing = 3.416 (5) Å].

The complex molecule of the title compound, [Rh2{N(C6H5)COCH3}4(C6H5CN)2], exhibits crystallographically imposed centrosymmetry. The four acetamide ligands bridging the dirhodium core are arranged in a 2,2-cis manner, with two N atoms and two O atoms coordinating to the unique RhII atom cis to one another. The Neq—Rh—Rh—Oeq torsion angles on the acetamide bridges vary between 1.62 (4) and 1.78 (4)°. The Rh—Rh bond length is 2.4319 (3) Å. The axial nitrile ligand completes the distorted octahedral coordination sphere and shows a non-linear coordination with an Rh—N—C bond angle of 167.14 (15)°, while the N—C bond length is 1.135 (3) Å.

Background: Increased access to HIV testing is essential in working towards universal access to HIV prevention and treatment in resource-limited countries. We here evaluated currently used HIV diagnostic tests and algorithms in Cameroon for their ability to correctly identify HIV infections. Methods: We estimated sensitivity, specificity, and positive and negative predictive values of 5 rapid/simple tests, of which 3 were used by the national program, and 2 fourth generation ELISAs. The reference panel included 500 locally collected samples; 187 HIV -1 M, 10 HIV-1 O, 259 HIV negative and 44 HIV indeterminate plasmas. Results: None of the 5 rapid assays and only 1 ELISA reached the current WHO/UNAIDS recommendations on performance of HIV tests of at least 99% sensitivity and 98% specificity. Overall, sensitivities ranged between 94.1% and 100%, while specificities were 88.0% to 98.8%. The combination of all assays generated up to 9% of samples with indeterminate HIV status, because they reacted discordantly with at least one of the different tests. Including HIV indeterminate samples in test efficiency calculations significantly decreased specificities to a range from 77.9% to 98.0%. Finally, two rapid assays failed to detect all HIV-1 group O variants tested, with one rapid test detecting only 2 out of 10 group O specimens. Conclusion: In the era of ART scaling-up in Africa, significant proportions of false positive but also false negative results are still observed with HIV screening tests commonly used in Africa, resulting in inadequate treatment and prevention strategies. Depending on tests or algorithms used, up to 6% of HIV-1 M and 80% of HIV-1 O infected patients in Cameroon do not receive ART and adequate counseling to prevent further transmission due to low sensitivities. Also, the use of tests with low specificities could imply inclusion of up to 12% HIV negative people in ART programs and increase budgets in addition to inconveniences caused to patients.

VCU Theses and Dissertations

In the title compound, [Rh2(C8H8NO)4(C8H7N)], the four acetamidate ligands bridging the dirhodium core are arranged in a 2,2-transmanner. One RhIIatom is five-coordinate, in a distorted pyramidal geometry, while the other is six-coordinate, with a disorted octahedral geometry. For the six-coordinate RhIIatom, the axial nitrile ligand shows a non-linear Rh–nitrile coordination with an Rh—N—C bond angle of 166.4 (4)° and a nitrile N—C bond length of 1.138 (6) Å. Each unique RhIIatom is coordinated by atranspair of N atoms and atranspair of O atoms from the four acetamide ligands. The Neq—Rh—Rh—Oeqtorsion angles on the acetamide bridge varies between 12.55 (11) and 14.04 (8)°. In the crystal, the 3-methylbenzonitrile ring shows a π–π interaction with an inversion-related equivalent [interplanar spacing = 3.360 (6) Å]. A phenyl ring on one of the acetamide ligands also has a face-to-face π–π interaction with an inversion-related equivalent [interplanar spacing = 3.416 (5) Å].

The complex molecule of the title compound, [Rh2{N(C6H5)COCH3}4(C6H5CN)2], exhibits crystallographically imposed centrosymmetry. The four acetamide ligands bridging the dirhodium core are arranged in a 2,2-cis manner, with two N atoms and two O atoms coordinating to the unique Rh(II) atom cis to one another. The Neq-Rh-Rh-Oeq torsion angles on the acetamide bridges vary between 1.62 (4) and 1.78 (4)°. The Rh-Rh bond length is 2.4319 (3) Å. The axial nitrile ligand completes the distorted octahedral coordination sphere and shows a non-linear coordination with an Rh-N-C bond angle of 167.14 (15)°, while the N-C bond length is 1.135 (3) Å.