Search

Acquired drug resistance (ADR) is common among adolescents living with perinatal HIV (APHI) in sub-Saharan Africa (SSA). Personalized management has the potential to improve pediatric antiretroviral therapy (ART), even in the presence of long-term treatment and HIV-1 subtype diversity. We sought to evaluate the effect of HIV-1 mutational profiling on immuno-virological response and ADR among APHI. A cohort-study was conducted from 2018-2020 among 311 APHI receiving ART in Cameroon. Clinical, immunological and virological responses were measured at enrolment (T1), 6-months (T2) and 12-months (T3). Immunological failure (IF: CD4 <250 cells/mm3), VF (viremia =1,000 copies/ml), and ADR were analyzed, with P<0.05 considered significant. Mean age was 15(±3) years; male-female ratio was 1:1; median [IQR] ART-duration was 36[21-81] months. At T1, T2, and T3 respectively, adherence-level was 66.4, 58.3 and 66.5%; 14 viral clades were found, driven by CRF02_AG (58.6%); ADR-mutations favored increased switch to second-line ART (16.1, 31.2, and 41.9%, P<0.0001). From T1-T3 respectively, there were declining rates of IF (25.5, 18.9, and 9.83%, P<0.0001), VF (39.7, 39.9, and 28.2%, P=0.007), and HIVDR (96.4, 91.7, and 85.0%, P=0.099). Predictors of ADR were being on first-line ART (P=0.045), high viremia at enrolment (AOR=12.56, P=0.059), and IF (AOR=5.86, P=0.010). Of note, optimized ART guided by mutational profile (AOR=0.05, P=0.002) was protective. Moreover, full Tenofovir+Lamivudine+ Dolutegravir efficacy was predicted in 77 and 62% of APHI respectively after first- and second-line failure. Among APHI in this SSA setting, viral mutational profiling prompts the use of optimized Dolutegravir-based ART regimens, leading to improved immuno-virological response and declining ADR burdens. Thus, implementing personalized HIV medicine in this vulnerable population would substantially improve ART response and the achievement of the 95-95-95 goals in these underserved populations. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB)‐related death has increased for the first time in a decade due to the coronavirus disease 2019 (COVID‐19), globally. People living with HIV (PLWHIV) might be at a higher risk of developing COVID‐19‐related complications. Herein, we describe the first case of a patient surviving from SARS‐CoV‐2‐TB‐HIV triple co‐infection in Cameroon. A 36‐year‐old Cameroonian woman presented at the emergency unit of the Jamot Hospital, Yaoundé with symptoms of anorexia, productive cough, weight loss, and fever. The SARS‐CoV‐2 rapid antigen test on nasopharyngeal sample was positive. Chest X‐ray showed bilateral parenchymal and tracheal calcifications most consistent with prior pulmonary histoplasmosis, varicella, or TB. She was tested HIV positive, and the sputum sample tested positive for TB on auramine staining. TB therapy (rifampicin, isoniazid, pyrazinamide, and ethambutol) and COVID‐19 treatment were initiated, and the symptoms improved after 2 weeks of treatment. The SARS‐CoV‐2 rapid antigen and real‐time polymerase chain reaction tests were negative after 2 weeks. She was discharged home on antiretroviral therapy and TB therapy. Coinfection with both TB, HIV, and SARS‐CoV‐2 may be common in Cameroon but not reported. The similar clinical features of COVID‐19 and TB usually lead to misdiagnosis. Early diagnosis and initiation of appropriate treatment improve outcome. COVID‐19, TB, and HIV are infectious diseases of global public health concern. Triple Co‐infection with these diseases can create a diagnostic and therapeutic dilemma. We present a 36‐year‐old Cameroonian woman who survived SARS‐CoV‐2 – HIV‐TB triple co‐infection. Timely diagnosis and appropriate management of these infections may improve outcomes and prevent complications. [ABSTRACT FROM AUTHOR]

Introduction: Wound infection is a significant clinical challenge in hospitals in developing countries where proper healthcare delivery is hampered by limited resources. This study investigated the antibiotic susceptibility pattern of bacteria causing wound infection and risk factors for infection among hospitalized patients in Buea, Cameroon, to generate findings which could drive reformation of policies on infection control. Methods: Aerobic bacteria were isolated from 212 swabs collected from patients with clinically diagnosed infected wounds. Risk factors for wound infection were investigated. Antibiotic susceptibility of isolates was determined by disk diffusion technique. The Chi-square test was employed to determine significant differences in isolation and distribution of organisms in various specimens. Differences were considered significant at P < 0.05. Results: Twelve bacteria species were isolated from 169 (79.7%) specimens. Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae, the predominant isolates in all wound types exhibited a high preponderance of multidrug resistant strains. High rate of infection was attributed to lack of constant water supply and breakdown of sterilization equipment during the study period. Highest diversity of pathogens occurred in open wounds. There were no significant differences (P>0.05) in isolation of pathogens with respect to age, gender and wound type. Co-existing morbidity increased risk of wound infection. Isolates were susceptible to fluoroquinolones and resistant to oxacillin. Conclusion: Wound infection with resistant bacteria constitutes a significant cause of morbidity in the study area. Findings reiterate the need to strengthen infection control and drug dispensing policies, and greater collaboration between microbiologists and medical practioners to stem the spread of resistant bacteria. [ABSTRACT FROM AUTHOR]