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Manzemu DG, Opara JPA, Kasai ET, Mumbere M, Kampunzu VM, Likele BB, Uvoya NA, Vanzwa HM, Bukaka GM, Dady FS, Dauly NN, Belec L, Tonen-Wolyec S. Rotavirus and adenovirus infections in children with acute gastroenteritis after introducing the Rotasiil® vaccine in Kisangani, Democratic Republic of the Congo. PLoS One 2024; 19:e0297219. [PMID: 38346035 PMCID: PMC10861064 DOI: 10.1371/journal.pone.0297219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/29/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Although rotavirus vaccination has reduced the global burden of the virus, morbidity and mortality from rotavirus infection remain high in Sub-Saharan Africa. This study aimed to determine the prevalence of rotavirus and adenovirus infections in children under five years with acute gastroenteritis and to identify factors associated with rotavirus infection after the introduction of the Rotasiil® vaccine in 2019 in Kisangani, Democratic Republic of the Congo (DRC). METHODS This study consisted of a cross-sectional hospital-based survey conducted from May 2022 to April 2023 in four health facilities in Kisangani, using a fecal-based test (rapid antigenic immuno-chromatographic diagnostic test, BYOSYNEX adenovirus/rotavirus BSS, Biosynex SA, Illkirch-Graffenstaden, France) of rotavirus and adenovirus infections among children under five years of age with acute gastroenteritis. RESULTS A total of 320 children under five years of age with acute gastroenteritis were included. The prevalence of rotavirus infection was 34.4%, that of adenovirus was 6.3%, and that of both rotavirus and adenovirus coinfection was 1.3%. The prevalence of rotavirus was significantly higher in unvaccinated children than in vaccinated children (55.4% versus 23.1%; P < 0.001). This difference was observed only in children who received all three vaccine doses. Multivariate logistic regression analysis shows that the rate of rotavirus infection was significantly reduced in vaccinated children (adjusted OR: 0.31 [95% confidence intervals (CI): 0.19-0.56]; P < 0.001) and those whose mothers had an average (adjusted OR: 0.51 [95% CI: 0.25-0.91]; P = 0.018) or high level (adjusted OR: 0.34 [95% CI: 0.20-0.64]; P < 0.001) of knowledge about the rotavirus vaccine. CONCLUSIONS The prevalence of rotavirus infection remains high in Kisangani despite vaccination. However, the prevalence of adenovirus infections was low in our series. Complete vaccination with three doses and mothers' average and high level of knowledge about the rotavirus vaccine significantly reduces the rate of rotavirus infection. It is, therefore, essential to strengthen the mothers' health education, continue with the Rotasiil® vaccine, and ensure epidemiological surveillance of rotavirus infection.
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Affiliation(s)
- Didier Gbebangi Manzemu
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Jean Pierre Alworong'a Opara
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Emmanuel Tebandite Kasai
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Mupenzi Mumbere
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
- Department of Pediatrics, Faculty of Medicine, Catholic University of the Graben, Butembo, Democratic Republic of the Congo
| | - Véronique Muyobela Kampunzu
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Bibi Batoko Likele
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Naura Apio Uvoya
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
- Department of Pediatrics, Faculty of Medicine, University of Bunia, Bunia, Democratic Republic of the Congo
| | - Hortense Malikidogo Vanzwa
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Gaspard Mande Bukaka
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Falay Sadiki Dady
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Nestor Ngbonda Dauly
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Laurent Belec
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, and University of Paris, Sorbonne Paris Cité, Paris, France
| | - Serge Tonen-Wolyec
- Department of Internal Medicine, Faculty of Medicine, University of Bunia, Bunia, Democratic Republic of the Congo
- Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
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Longo JDD, Woromogo SH, Diemer HSC, Tékpa G, Belec L, Grésenguet G. Incidence and risk factors for tuberculosis among people living with HIV in Bangui: A cohort study. Public Health Pract (Oxf) 2022; 4:100302. [PMID: 36570403 PMCID: PMC9773039 DOI: 10.1016/j.puhip.2022.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/06/2022] [Accepted: 07/20/2022] [Indexed: 12/27/2022] Open
Abstract
Objectives The objectives of this study were to determine the incidence and risk factors of tuberculosis (TB) among people living with HIV (PLHIV). Methods A cohort study was carried out in an HIV infection management centre in Bangui. PLHIV aged 18 or older, with no history of TB, enrolled between January 1, 2017 and December 31, 2018 were included in the study. The chi-square test was used only to compare the proportions at the 5% significance level. To determine the risk factors, we used the Cox regression adjusted hazard ratio, using Epi Info 7 software. Results A total of 677 patients including 618 (91.28%) on antiretroviral therapy were included in the study. The median age was 34 with extremes ranging from 18 to 57. Of the patients followed, 104 developed TB. The overall incidence of TB was 15.37 (104/677) cases per 100 PLHIV-years. This incidence was 13.10 (81/618) cases per 100 in patients on ART-years and 38.99 (23/59) cases per 100 patients on pre-ART-years. In pre-ART patients the incidence of TB was therefore almost 3 times higher than that of PLHIV on ART (p = 0.03). WHO clinical stages III and IV (p = 0.02), absence of ART (p = 0.03), poor adherence (p = 0.004) and low functional capacity (p = 0.04) were the risk factors associated with the occurrence of TB among PLHIV in Bangui. Conclusions The high incidence of TB in our context is essentially linked to delay in diagnosis and the quality of care. Early initiation of antiretroviral therapy, systematic screening for TB in PLHIV upon entry into the active queue and better monitoring of patients on ART are strongly recommended.
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Affiliation(s)
- Jean De Dieu Longo
- National Reference Centre for Sexually Transmitted Diseases and Antiretroviral Therapy, Bangui, Central African Republic,Research and Intervention Unit on Sexually Transmitted Diseases and AIDS and AIDS, Department of Public Health, Faculty of Health Sciences, Bangui, Central African Republic
| | - Sylvain Honoré Woromogo
- Inter State Centre of Higher Education in Public Health of Central Africa, Brazzaville, Congo,Department of Public Health, Faculty of Health Sciences, Bangui, Central African Republic,Corresponding author. Department of Public Health, Faculty of Health Sciences, Bangui, Central African Republic.
| | - Henri Saint-Calvaire Diemer
- National Reference Centre for Sexually Transmitted Diseases and Antiretroviral Therapy, Bangui, Central African Republic,Research and Intervention Unit on Sexually Transmitted Diseases and AIDS and AIDS, Department of Public Health, Faculty of Health Sciences, Bangui, Central African Republic
| | - Gaspard Tékpa
- Research and Intervention Unit on Sexually Transmitted Diseases and AIDS and AIDS, Department of Public Health, Faculty of Health Sciences, Bangui, Central African Republic
| | - Laurent Belec
- Microbiology Laboratory, Georges Pompidou European Hospital, Paris Public Hospitals, and Faculty of Medicine Paris Descartes, Université Paris Descartes, Sorbonne Paris City, Paris, France
| | - Gérard Grésenguet
- National Reference Centre for Sexually Transmitted Diseases and Antiretroviral Therapy, Bangui, Central African Republic,Research and Intervention Unit on Sexually Transmitted Diseases and AIDS and AIDS, Department of Public Health, Faculty of Health Sciences, Bangui, Central African Republic
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3
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Mossoro-Kpinde CD, Bobossi C, Tonen-Wolyec S, Kalla GCM, Baguida-Bokia C, Sombot-Ndicki S, Gresenguet G, Mbopi-Keou FX, Belec L. Analytical performances of Exacto® HIV self-test in the Central African Republic. Pan Afr Med J 2022; 41:236. [PMID: 35721654 PMCID: PMC9167446 DOI: 10.11604/pamj.2022.41.236.31220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/17/2022] [Indexed: 11/11/2022] Open
Abstract
We herein evaluated the analytical performances of the CE-IVD capillary blood Exacto® HIV self-test (Biosynex, Strasbourg, France) in the Central African Republic (CAR). A cross-sectional study was conducted on a representative national panel of 200 sera positive for HIV and 200 negative for HIV, randomly selected thorough the CAR for HIV seroprevalence surveillance survey, according to reference test. The Exacto® HIV self-test showed 99.5% (95% CI: 98.2-99.9) sensitivity and 100.0% (95% CI: 99.0-100.0) specificity. The Youden´s J index and Cohen´s Kappa coefficient were 0.995. At HIV-1 seroprevalence of 3.5% in the general adult population of the CAR, the positive and negative predictive values were 100% (95% CI: 99.0-100) and 99.9% (95% CI: 98.9-100), respectively. The results are within the limits required by the WHO (i.e. sensitivity ≥ 99.0% and specificity ≥ 98.0%), making Exacto® HIV self-test suitable for routine use in the CAR.
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Affiliation(s)
- Christian Diamant Mossoro-Kpinde
- Laboratoire National de Biologie Clinique et de Santé Publique, Bangui, République Centrafricaine
- Faculté des Sciences de la Santé, Université de Bangui, Bangui, République Centrafricaine
- Corresponding author: Christian Diamant Mossoro-Kpinde, Laboratoire National de Biologie Clinique et de Santé Publique, Bangui, République Centrafricaine.
| | - Christelle Bobossi
- Laboratoire National de Biologie Clinique et de Santé Publique, Bangui, République Centrafricaine
| | - Serge Tonen-Wolyec
- Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, République Démocratique du Congo
| | | | - Coretha Baguida-Bokia
- Laboratoire National de Biologie Clinique et de Santé Publique, Bangui, République Centrafricaine
| | - Simplice Sombot-Ndicki
- Laboratoire National de Biologie Clinique et de Santé Publique, Bangui, République Centrafricaine
| | - Gerard Gresenguet
- Faculté des Sciences de la Santé, Université de Bangui, Bangui, République Centrafricaine
| | | | - Laurent Belec
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris Sorbonne Cité, Paris, France
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4
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Kernéis S, Planas D, Imbeaud S, Staropoli I, Puech J, Robillard N, Rodary J, Bruel T, Vieillard T, Schwartz O, Belec L, Péré H, Veyer D. Transmission of SARS-CoV-2 Alpha Variant (B.1.1.7) From a BNT162b2-Vaccinated Individual. Open Forum Infect Dis 2021; 8:ofab369. [PMID: 34377731 PMCID: PMC8339281 DOI: 10.1093/ofid/ofab369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/08/2021] [Indexed: 11/14/2022] Open
Abstract
Cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) acquisition after vaccination with BNT162b2 have been described, but the risk of secondary transmission from fully vaccinated individuals remains ill defined. Herein we report a confirmed transmission of SARS-CoV-2 alpha variant (B.1.1.7) from a symptomatic immunocompetent woman 4 weeks after her second dose of BNT162b2, despite antispike seroconversion.
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Affiliation(s)
- Solen Kernéis
- Equipe de Prévention du Risque Infectieux, AP-HP, Hôpital Bichat, Paris, France.,Université de Paris, INSERM, IAME, Paris, France
| | - Delphine Planas
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR3569, Paris, France.,Vaccine Research Institute, Faculté de Médecine, INSERM U955, Université Paris-Est Créteil , Créteil, France
| | - Sandrine Imbeaud
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, INSERM U1138, Paris, France
| | - Isabelle Staropoli
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR3569, Paris, France.,Vaccine Research Institute, Faculté de Médecine, INSERM U955, Université Paris-Est Créteil , Créteil, France
| | - Julien Puech
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Nicolas Robillard
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Julien Rodary
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Timothée Bruel
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR3569, Paris, France.,Vaccine Research Institute, Faculté de Médecine, INSERM U955, Université Paris-Est Créteil , Créteil, France
| | | | - Olivier Schwartz
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR3569, Paris, France.,Vaccine Research Institute, Faculté de Médecine, INSERM U955, Université Paris-Est Créteil , Créteil, France
| | - Laurent Belec
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.,INSERM U970, PARCC, Hôpital Européen Georges Pompidou, Faculté de Médecine, Université de Paris, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France
| | - Hélène Péré
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, INSERM U1138, Paris, France
| | - David Veyer
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, INSERM U1138, Paris, France.,Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
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5
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Planas D, Veyer D, Baidaliuk A, Staropoli I, Guivel-Benhassine F, Rajah MM, Planchais C, Porrot F, Robillard N, Puech J, Prot M, Gallais F, Gantner P, Velay A, Le Guen J, Kassis-Chikhani N, Edriss D, Belec L, Seve A, Courtellemont L, Péré H, Hocqueloux L, Fafi-Kremer S, Prazuck T, Mouquet H, Bruel T, Simon-Lorière E, Rey FA, Schwartz O. Reduced sensitivity of SARS-CoV-2 variant Delta to antibody neutralization. Nature 2021; 596:276-280. [PMID: 34237773 DOI: 10.1038/s41586-021-03777-9] [Citation(s) in RCA: 1370] [Impact Index Per Article: 456.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/29/2021] [Indexed: 12/27/2022]
Abstract
The SARS-CoV-2 B.1.617 lineage was identified in October 2020 in India1-5. Since then, it has become dominant in some regions of India and in the UK, and has spread to many other countries6. The lineage includes three main subtypes (B1.617.1, B.1.617.2 and B.1.617.3), which contain diverse mutations in the N-terminal domain (NTD) and the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein that may increase the immune evasion potential of these variants. B.1.617.2-also termed the Delta variant-is believed to spread faster than other variants. Here we isolated an infectious strain of the Delta variant from an individual with COVID-19 who had returned to France from India. We examined the sensitivity of this strain to monoclonal antibodies and to antibodies present in sera from individuals who had recovered from COVID-19 (hereafter referred to as convalescent individuals) or who had received a COVID-19 vaccine, and then compared this strain with other strains of SARS-CoV-2. The Delta variant was resistant to neutralization by some anti-NTD and anti-RBD monoclonal antibodies, including bamlanivimab, and these antibodies showed impaired binding to the spike protein. Sera collected from convalescent individuals up to 12 months after the onset of symptoms were fourfold less potent against the Delta variant relative to the Alpha variant (B.1.1.7). Sera from individuals who had received one dose of the Pfizer or the AstraZeneca vaccine had a barely discernible inhibitory effect on the Delta variant. Administration of two doses of the vaccine generated a neutralizing response in 95% of individuals, with titres three- to fivefold lower against the Delta variant than against the Alpha variant. Thus, the spread of the Delta variant is associated with an escape from antibodies that target non-RBD and RBD epitopes of the spike protein.
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Affiliation(s)
- Delphine Planas
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR 3569, Paris, France.,Vaccine Research Institute, Creteil, France
| | - David Veyer
- INSERM, Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordeliers, Université de Paris and Sorbonne Université, Paris, France.,Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Artem Baidaliuk
- G5 Evolutionary Genomics of RNA Viruses, Department of Virology, Institut Pasteur, Paris, France
| | - Isabelle Staropoli
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR 3569, Paris, France
| | | | - Maaran Michael Rajah
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR 3569, Paris, France.,Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Cyril Planchais
- Laboratory of Humoral Immunology, Department of Immunology, Institut Pasteur, INSERM U1222, Paris, France
| | - Françoise Porrot
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR 3569, Paris, France
| | - Nicolas Robillard
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Julien Puech
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Matthieu Prot
- G5 Evolutionary Genomics of RNA Viruses, Department of Virology, Institut Pasteur, Paris, France
| | - Floriane Gallais
- CHU de Strasbourg, Laboratoire de Virologie, Strasbourg, France.,Université de Strasbourg, INSERM, IRM UMR_S 1109, Strasbourg, France
| | - Pierre Gantner
- CHU de Strasbourg, Laboratoire de Virologie, Strasbourg, France.,Université de Strasbourg, INSERM, IRM UMR_S 1109, Strasbourg, France
| | - Aurélie Velay
- CHU de Strasbourg, Laboratoire de Virologie, Strasbourg, France.,Université de Strasbourg, INSERM, IRM UMR_S 1109, Strasbourg, France
| | - Julien Le Guen
- Service de Gériatrie, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Najiby Kassis-Chikhani
- Unité d'Hygiène Hospitalière, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Dhiaeddine Edriss
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Laurent Belec
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Aymeric Seve
- CHR d'Orléans, Service de Maladies Infectieuses, Orléans, France
| | | | - Hélène Péré
- INSERM, Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordeliers, Université de Paris and Sorbonne Université, Paris, France
| | | | - Samira Fafi-Kremer
- CHU de Strasbourg, Laboratoire de Virologie, Strasbourg, France.,Université de Strasbourg, INSERM, IRM UMR_S 1109, Strasbourg, France
| | - Thierry Prazuck
- CHR d'Orléans, Service de Maladies Infectieuses, Orléans, France
| | - Hugo Mouquet
- Laboratory of Humoral Immunology, Department of Immunology, Institut Pasteur, INSERM U1222, Paris, France
| | - Timothée Bruel
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR 3569, Paris, France. .,Vaccine Research Institute, Creteil, France.
| | - Etienne Simon-Lorière
- G5 Evolutionary Genomics of RNA Viruses, Department of Virology, Institut Pasteur, Paris, France
| | - Felix A Rey
- Structural Virology Unit, Department of Virology, Institut Pasteur, CNRS UMR 3569, Paris, France
| | - Olivier Schwartz
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR 3569, Paris, France. .,Vaccine Research Institute, Creteil, France.
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Tonen-Wolyec S, Kayembe Tshilumba C, Batina-Agasa S, Marini Djang'eing'a R, Hayette MP, Belec L. Comparison of practicability and effectiveness between unassisted HIV self-testing and directly assisted HIV self-testing in the Democratic Republic of the Congo: a randomized feasibility trial. BMC Infect Dis 2020; 20:830. [PMID: 33176700 PMCID: PMC7656730 DOI: 10.1186/s12879-020-05554-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 10/27/2020] [Indexed: 11/24/2022] Open
Abstract
Background HIV self-testing (HIVST) can be performed using directly assisted and unassisted approaches in facilities or communities to reach different populations. The aim of this study was to compare the practicability and effectiveness of the two delivery approaches for HIVST, unassisted HIVST (UH) and directly assisted HIVST (DAH), in the field setting of Kisangani, the Democratic Republic of the Congo (DRC). Methods A randomized (1:1), non-blinded, non-inferiority trial using a blood-based and facility-based HIVST method was carried out in four facilities in Kisangani, the DRC, targeting populations at high risk for HIV infection. The primary outcome was the difference in the practicability of the HIV self-test between the two arms. Practicability was defined as successfully performing the test and correctly interpreting the result. Requests for assistance, positivity rate, linkage to care, and willingness to buy an HIV self-test kit constituted the secondary outcomes for HIVST effectiveness. The adjusted risk ratios (aRRs) were calculated using Poisson regression. Results The rate of successfully performing the test was same (93.2%) in the UH and DAH arms. The rate of correctly interpreting the results was 86.9% in the UH arm versus 93.2% in the DAH arm, for a difference of − 6.3%. After the follow-up 72 h later, participants in the UH arm had a significantly lower chance of correctly interpreting the test results than those in the DAH arm (aRR: 0.60; P = 0.019). Although the positivity rate was 3.4% among the participants in the DAH arm and 1.7% among those in the UH arm, no significant differences were found between the two arms in the positivity rate, requests for assistance, and linkage to care. Willingness to buy an HIV self-test was higher in the UH arm than in the DAH arm (92.3% versus 74.1%; aRR: 4.20; P < 0.001). Conclusion The results of this study indicate that UH is as practicable and effective as DAH among individuals at high risk for HIV infection in Kisangani, the DRC. However, additional support tools need to be assessed to improve the interpretation of the self-test results when using the UH approach. Trial registration PACTR201904546865585. Registered 03 April 2019 - Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=6032
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Affiliation(s)
- Serge Tonen-Wolyec
- Ecole Doctorale Régionale D'Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon. .,Department of Internal Medicine, Faculty de Medicine, University of Bunia, Bunia, Democratic Republic of the Congo. .,Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo.
| | - Charles Kayembe Tshilumba
- Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Salomon Batina-Agasa
- Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Roland Marini Djang'eing'a
- Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo.,Department of Pharmaceutical Sciences, Laboratory of Analytical Chemistry, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Marie-Pierre Hayette
- Department of Clinical Microbiology, University Hospital of Liège, Liege, Belgium
| | - Laurent Belec
- Laboratory of virology, Hôpital Européen Georges Pompidou, and University of Paris Descartes, Paris Sorbonne Cité, Paris, France
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7
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Mboumba Bouassa R, Belec L, Gubavu C, Péré H, Colin M, Veyer D, Gravier A, Hocqueloux L, Prazuck T. Infection anale à HR-HPV, chez des hommes ayant des rapports sexuels avec des hommes après une année de PrEP. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Soayfane Z, Houshaymi B, Kedees MH, Belec L, Nasreddine N. Cell Proteins Interacting with the Human Immunodeficiency Virus in Immunoblotting can be Detected by R5- or X4- Tropic Human Immunodeficiency Virus Particles. Int J Appl Basic Med Res 2020; 10:81-85. [PMID: 32566522 PMCID: PMC7289202 DOI: 10.4103/ijabmr.ijabmr_398_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/27/2019] [Accepted: 01/06/2020] [Indexed: 12/01/2022] Open
Abstract
Introduction: The present study reported a new immunoblot assay, with revelation by R5- or X4-whole free human immunodeficiency virus (HIV) particles or recombinant gp160. Materials and Methods: The assay was optimized to identify cell proteins interacting with HIV. Whole cell lysates were prepared from peripheral blood lymphocytes (PBLs), dendritic cells (DC), monocyte-derived macrophage (MDM), and Henrietta Lacks (Hela, wild-type or transfected with DC-specific intracellular adhesion molecule-3-Grabbing Non-Integrin, HeLa) and Human endometrial cells (HEC-1A) lines; HIV particles used were the R5-tropic HIV-1JRCSF and the X4-tropic HIV-1NDK. Results: Experiments with PBL lysates and both viruses demonstrated different bands, including a unique band at 105–117 kDa in addition to nonspecific bands. The 105–117 kDa band migrated at the same level of that observed in controls using total PBL lysate and anti-CD4 mAb for detection and thus likely corresponds to the cluster difference (CD) 4 complex. Blots using lysates of DCs, MDM, HeLa cell line, and HEC-1A cell line allowed identifying several bands that positions were similar to that seen by recombinant gp160 or whole R5- or X4-HIV particles. Conclusion: Blot of whole lysates of various HIV target cells is recognized by free HIV particles and allows identifying a wide range of HIV-interacting cell proteins. Such optimized assay could be useful to recognize new cellular HIV attachment proteins.
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Affiliation(s)
- Zeina Soayfane
- Department of Cell Biology, Faculty of Science, Lebanese University, Beirut, Lebanon
| | - Bilal Houshaymi
- Department of Microbiology, Faculty of Health, Lebanese University, Beirut, Lebanon
| | - Mamdouh H Kedees
- Department of Cell Biology, State University of New York, New York, NY, USA
| | - Laurent Belec
- Virology Lab, Georges Pompidou European Hospital, and University of Paris Descartes, Paris, France
| | - Nadine Nasreddine
- Department of Microbiology, Faculty of Health, Lebanese University, Beirut, Lebanon
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9
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Mboumba Bouassa RS, Pere H, Mossoro-Kpinde CD, Roques P, Gody JC, Moussa S, Veyer D, Gresenguet G, Charpentier C, Jenabian MA, Djoba Siawaya JF, Belec L. Purifying Selection in Human Immunodeficiency Virus-1 pol Gene in Perinatally Human Immunodeficiency Virus-1-Infected Children Harboring Discordant Immunological Response and Virological Nonresponse to Long-Term Antiretroviral Therapy. J Clin Med Res 2020; 12:369-376. [PMID: 32587653 PMCID: PMC7295550 DOI: 10.14740/jocmr4157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/23/2020] [Indexed: 11/11/2022] Open
Abstract
Background Biological monitoring of antiretroviral treatment (ART) in human immunodeficiency virus (HIV)-infected pediatric population remains challenging. The aim of the present study was to assess the long-term HIV-1 genetic diversity in pol gene in HIV-1-infected children in virological failure under antiretroviral regimen adapted according to the successive World Health Organization (WHO) guidelines for resource-constrained settings. Methods HIV-1 diversity in pol gene was assessed in HIV-1-infected children and adolescents born from HIV-infected mothers (median age at follow-up: 13.8 years) in virological failure (VF+) despite long-term regimen recommended by the WHO. The numbers of nonsynonymous substitutions per potential nonsynonymous site (dN) and of synonymous substitutions at potential synonymous sites (dS) in HIV-1 pol gene and the dN/dS ratios were used to estimate the selective pressure on circulating HIV-1. Results The immunological responses to ART basically corresponded to: 1) Full therapeutic failure with immunological (I-) and virological nonresponses in one-quarter (24.6%) of study children ((I-, VF+) subgroup); 2) Discordant immunovirological responses with paradoxical high CD4 T cell counts (I+) and high HIV-1 RNA load in the remaining cohort patients (75.4%) ((I+, VF+) subgroup). The mean dS was 1.8-fold higher in (I+, VF+) than (I-, VF+) subgroup (25.9 ± 18.4 vs. 14.3 ± 10.8). In the (I+, VF+) subgroup, the mean dS was 1.6-fold higher than the mean dN. Finally, the mean dN/dS ratio was 2.1-fold lower in (I+, VF+) than (I-, VF+) subgroup (0.6 ± 0.3 vs. 1.3 ± 0.7), indicating purifying selection in the immunovirological discordant (I+, VF+) subgroup and positive selection in the immunovirological failure (I-, VF+) subgroup. Conclusions Children and adolescents in immunovirological therapeutic failure harbor positive selection of HIV-1 strains favoring diversifying in pol-encoded amino acids. In contrast, children with persistent discordant immunovirological responses show accumulation of mutations and purifying selection in pol gene sequences, indicating limited genetic evolution and likely suggesting genetic adaptation of viruses to host functional constraints.
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Affiliation(s)
- Ralph-Sydney Mboumba Bouassa
- Laboratoire de Virologie, Hopital Europeen Georges Pompidou, Assistance Publique-Hopitaux de Paris (AP-HP) and Universite de Paris, Paris Sorbonne Cite, Paris, France.,Ecole Doctorale Regionale en Infectiologie Tropicale, Franceville, Gabon
| | - Helene Pere
- Laboratoire de Virologie, Hopital Europeen Georges Pompidou, Assistance Publique-Hopitaux de Paris (AP-HP) and Universite de Paris, Paris Sorbonne Cite, Paris, France.,Universite de Paris, Paris Sorbonne Cite, Paris, France
| | - Christian Diamant Mossoro-Kpinde
- Faculte des Sciences de la Sante, Universite de Bangui, Bangui, Central African Republic.,Laboratoire National de Biologie Clinique et de Sante Publique, Bangui, Central African Republic
| | - Pierre Roques
- Commissariat a l'Energie Atomique (CEA)-Universite Paris-Saclay; INSERM U1184, Immunology of Viral Infections and Autoimmune Diseases (IMVA), IDMIT Department, Institut de Biologie Francois-Jacob (IBJF), Fontenay-aux-Roses, France
| | - Jean Chrysostome Gody
- Faculte des Sciences de la Sante, Universite de Bangui, Bangui, Central African Republic.,Complexe Pediatrique, Bangui, Central African Republic
| | - Sandrine Moussa
- Institut Pasteur de Bangui, Bangui, Central African Republic
| | - David Veyer
- Laboratoire de Virologie, Hopital Europeen Georges Pompidou, Assistance Publique-Hopitaux de Paris (AP-HP) and Universite de Paris, Paris Sorbonne Cite, Paris, France
| | - Gerard Gresenguet
- Faculte des Sciences de la Sante, Universite de Bangui, Bangui, Central African Republic.,Unite de Recherches et d'Intervention sur les Maladies Sexuellement Transmissibles et le SIDA, Departement de Sante Publique, Faculte des Sciences de la Sante de Bangui, Central African Republic
| | - Charlotte Charpentier
- IAME, UMR 1137, INSERM, Universite Paris Diderot, Sorbonne Paris Cite, AP-HP, Laboratoire de Virologie, Hopital Bichat, AP-HP, Paris, France
| | - Mohammad-Ali Jenabian
- Departement des Sciences Biologiques et Centre de Recherche BioMed, Universite du Quebec a Montreal (UQAM), Montreal, QC, Canada
| | - Joel Fleury Djoba Siawaya
- Ecole Doctorale Regionale en Infectiologie Tropicale, Franceville, Gabon.,Laboratory Medicine, Mother and Child University Hospital Jeanne Ebori, Libreville, Gabon
| | - Laurent Belec
- Laboratoire de Virologie, Hopital Europeen Georges Pompidou, Assistance Publique-Hopitaux de Paris (AP-HP) and Universite de Paris, Paris Sorbonne Cite, Paris, France.,Ecole Doctorale Regionale en Infectiologie Tropicale, Franceville, Gabon.,Universite de Paris, Paris Sorbonne Cite, Paris, France
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10
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Mbopi-Keou FX, Kalla GCM, Voundi EV, Jenabian MA, Mboumba Bouassa RS, Talla F, Angwafo FF, Belec L. Differential influence of race and environment on indeterminate reactivities to non-treponemal and treponemal antigens by immuno-chromatographic dual syphilis rapid test. Pan Afr Med J 2019; 33:90. [PMID: 31489068 PMCID: PMC6711684 DOI: 10.11604/pamj.2019.33.90.16437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 05/27/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction Syphilis rapid test results may be influenced by numerous environmental and genetic factors. Methods The proportion of false positive syphilis non-treponemal (NT) and treponemal (T) test results using immuno-chromatographic dual syphilis rapid test on serum from Cameroonian blacks (n=103) versus French blacks (n=104) or French caucasians (n=51), all HIV-negative and free of clinical syphilis, was examined. Results Black individuals in Cameroon had a significantly higher frequency of false positive NT or T tests than black individuals in France. black individuals in France had a higher frequency of indeterminate NT tests as compared to caucasians in France. Conclusion Both racial and environmental factors may affect immuno-chromatographic dual syphilis rapid testing.
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Affiliation(s)
- Francois-Xavier Mbopi-Keou
- University of Yaounde I, Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.,The Institute for the Development of Africa (The-IDA), Yaoundé, Cameroon.,UNAIDS Scientific and Technical Advisory Committee (STAC)
| | | | - Esther Voundi Voundi
- University of Yaounde I, Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon
| | - Mohammad-Ali Jenabian
- Department of Biological Sciences and BioMed Research Centre, Université du Québec à Montréal (UQAM), Montréal, Québec, Canada
| | - Ralph-Sydney Mboumba Bouassa
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Fru F Angwafo
- University of Yaounde I, Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.,Gynecologic and Pediatric Hospital, Yaoundé, Cameroon
| | - Laurent Belec
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.,Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
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11
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Mboumba Bouassa RS, Nodjikouambaye ZA, Sadjoli D, Adawaye C, Péré H, Veyer D, Matta M, Robin L, Tonen-Wolyec S, Moussa AM, Koyalta D, Belec L. High prevalence of cervical high-risk human papillomavirus infection mostly covered by Gardasil-9 prophylactic vaccine in adult women living in N'Djamena, Chad. PLoS One 2019; 14:e0217486. [PMID: 31158254 PMCID: PMC6546217 DOI: 10.1371/journal.pone.0217486] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 05/13/2019] [Indexed: 01/27/2023] Open
Abstract
Background We conducted in 2018 a descriptive, quantitative, population-based, cross-sectional survey estimating the prevalence of cervical high-risk human papillomavirus (HR-HPV) infection and associated risk factors among adult women living in N’Djamena, Chad. Methods Five of the 10 districts of N’Djamena were randomly selected for inclusion. Peer educators contacted adult women in community-churches or women association networks to participate in the survey and come to the clinic for women’s sexual health “La Renaissance Plus”, N’Djamena. Medical, socio-demographical and behavioral informations were collected. HPV DNA was detected and genotyped in endocervical swab using Anyplex II HPV28 genotyping test (Seegene, Seoul, South Korea). Results 253 women (mean age, 35.0 years; range, 25–65) including 3.5% of HIV-positive women were prospectively enrolled. The prevalence of HPV infection was 22.9%, including 68.9% of HR-HPV infection and 27.6% being infected with multiple genotypes, providing a total HR-HPV prevalence of 15.8% (95% CI%: 11.3–20.3). The most prevalent HR-HPV genotypes were HPV-58, HPV-35, HPV-56, HPV-31, HPV-16, HPV-45, HPV-52 and HPV-18. HPV types targeted by the prophylactic Gardasil-9 vaccine were detected in nearly 70% (67.5%) and HPV-58 was the most frequently detected. HIV infection was a risk factor strongly associated with cervical infection with any HPV [adjusted Odds ratio (aOR): 17.4], multiple types of HPV (aOR: 8.9), HR-HPV (aOR: 13.2) and cervical infection with multiple HR-HPV (aOR: 8.4). Conclusion These observations highlight the unsuspected high burden of cervical HR-HPV infection in Chadian women, and point the potential risk of further development of HPV-associated cervical precancerous and neoplastic lesions in a large proportion of women in Chad. The high rate of preventable Gardasil-9 vaccine genotypes constitutes the rationale for introducing primary vaccine prevention against cervical cancer in young female adolescents living in Chad.
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Affiliation(s)
- Ralph-Sydney Mboumba Bouassa
- Ecole Doctorale Régionale d’Infectiologie Tropicale de Franceville, Franceville, Gabon
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - Zita Aleyo Nodjikouambaye
- Ecole Doctorale Régionale d’Infectiologie Tropicale de Franceville, Franceville, Gabon
- Service de Gynécologie-Obstétrique, Hôpital de la Mère et de l’Enfant, N’Djamena, Chad
- Cabinet Médical de Gynécologie Obstétrique “La Renaissance Plus,” N’Djamena, Chad
- * E-mail:
| | - Damtheou Sadjoli
- Service de Gynécologie-Obstétrique, Hôpital de la Mère et de l’Enfant, N’Djamena, Chad
- Cabinet Médical de Gynécologie Obstétrique “La Renaissance Plus,” N’Djamena, Chad
- Faculté des Sciences de la Santé Humaine, Université de N’Djamena, N’Djamena, Chad
| | - Chatté Adawaye
- Institut National Supérieur des Sciences et Techniques d’Abéché, Abéché, Chad
| | - Hélène Péré
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - David Veyer
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - Mathieu Matta
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - Leman Robin
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - Serge Tonen-Wolyec
- Ecole Doctorale Régionale d’Infectiologie Tropicale de Franceville, Franceville, Gabon
- Faculté de Médecine, Université de Bunia, Bunia, Democratic Republic of the Congo
- Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, Democratic Republic of the Congo
| | - Ali Mahamat Moussa
- Faculté des Sciences de la Santé Humaine, Université de N’Djamena, N’Djamena, Chad
- Service de Gastro-entérologie, Hôpital Général de Référence Nationale, N’Djamena, Chad
| | | | - Laurent Belec
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
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12
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Mboumba Bouassa RS, Mbeko Simaleko M, Camengo SP, Mossoro-Kpinde CD, Veyer D, Matta M, Robin L, Longo JDD, Grésenguet G, Péré H, Meye JF, Belec L. Unusual and unique distribution of anal high-risk human papillomavirus (HR-HPV) among men who have sex with men living in the Central African Republic. PLoS One 2018; 13:e0197845. [PMID: 29795661 PMCID: PMC5967740 DOI: 10.1371/journal.pone.0197845] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 04/27/2018] [Indexed: 12/05/2022] Open
Abstract
Background High-risk (HR) human papillomavirus (HPV) infection remains a great concern in relation to African men who have sex with men (MSM), especially those infected with HIV. The prevalence of HR-HPV and associated risk factors was estimated in a cross-sectional observational study covering MSM living in Bangui, Central African Republic. Methods MSM receiving care at the Centre National de Référence des Infections Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, were included. HIV serostatus and socio-demographic and behavioral characteristics were collected. HPV DNA was detected and genotyped on anal swabs using Anyplex™ II HPV28 test (Seegene, South Korea), and HSV DNA by in-house real-time PCR. Logistic regression analyses were used to determine risk factors associated with HPV outcomes. Results 42 MSM (mean age, 23.2 years; range, 14–39) including 69.1% HIV-1-positive and 30.9% HIV-negative were prospectively enrolled. The prevalence of anal HPV was 69.1%, including 82.7% of HR-HPV which were multiple in 52.0%. The most prevalent genotypes were HPV-35, HPV-58, HPV-59 and HPV-31. While, HPV-16 and HPV-18 were present in a minority of samples. Multiple HR-HPV infection was more frequent in HIV-positive MSM (41.4%) with 2.7 genotypes per anal samples than in HIV-negative (7.7%) with 1.5 genotypes per anal samples. HPV types included in the prophylactic Gardasil-9® vaccine were detected in 68.9% of specimens and HPV-58 was the most frequently detected. MSM infected by HPV-16 and HPV-18 were all infected by HIV-1. Few anal swabs (11.9%) contained HSV-2 DNA without relationship with HPV detection. Condomless receptive anal intercourse was the main risk factor to being infected with any type of HPV and condomless insertive anal intercourse was significantly less associated with HPV contamination than receptive anal intercourse (Odd ratio = 0.02). Conclusion MSM in Bangui are at-risk of HIV and HR-HPV anal infections. The unusual distribution of HPV-35 as predominant HPV suggests possible geographic specificities in the molecular epidemiology of HR-HPV in sub-Saharan Africa. Scaling up prevention strategies against HPV infection and related cancers adapted for MSM in Africa should be prioritized. Innovative interventions should be conceived for the MSM population living in Bangui.
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Affiliation(s)
- Ralph-Sydney Mboumba Bouassa
- Ecole Doctorale Régionale d’Infectiologie Tropicale de Franceville, Franceville, Gabon
- Ecole Doctorale Bio Sorbonne Paris Cité, BioSPC, Paris Descartes, Paris, France
| | - Marcel Mbeko Simaleko
- Centre National de Référence des Infection Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
| | - Serge Police Camengo
- Servivce de Gastro-entérologie, Hôpital de l’Amitié, Bangui, Central African Republic
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
| | - Christian Diamant Mossoro-Kpinde
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
- Laboratoire National de Biologie Clinique et de Santé Publique, Bangui, Central African Republic
- * E-mail:
| | - David Veyer
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Mathieu Matta
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Leman Robin
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jean De Dieu Longo
- Centre National de Référence des Infection Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
- Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et le SIDA, Département de Santé Publique, Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
| | - Gérard Grésenguet
- Centre National de Référence des Infection Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
- Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et le SIDA, Département de Santé Publique, Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
| | - Hélène Péré
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jean-François Meye
- Service de Gynécologie Obstétrique, Centre Hospitalo-Universitaire d’Angondjé, Libreville et Faculté de Médecine de Libreville, Université des Sciences de la Santé, Libreville, Gabon
| | - Laurent Belec
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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13
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Lozinguez O, Arnaud E, Belec L, Nicaud V, Alhenc-Gelas M, Fiessinger JN, Aiach M, Emmerich J. Demonstration of an Association between Chlamydia pneumoniae Infection and Venous Thromboembolic Disease. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613938] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Chlamydia pneumoniae infection has been linked to atherosclerosis, but a possible relationship with venous thromboembolism (VTE) has not been sought. We determined circulating anti-C. pneumoniae antibody levels in patients with VTE. We studied 176 case patients with objectively diagnosed VTE and 197 age-and sex-matched healthy controls, in a retrospective study. Acquired risk factors for VTE and frequent predisposing genetic factors (factor V Arg 506 Gln and factor II G 20210 A mutations) were assessed in all the subjects. Anti-C. pneumoniae IgG antibodies were determined by microimmunofluorescence. All positive plasma samples (titer ≥128) were precisely quantified and tested for the presence of specific IgM antibodies. Fiftyfour percent of the cases and 15.9% of the controls had specific IgG titers of at least 256 (p <0.0001). The crude odds ratio for VTE was 6.2 (95% CI, 3.8-10.1), and rose to 7.7 (4.5-13.2) after excluding subjects carrying the factor V Arg 506 Gln or factor II G 20210 A mutations. The odds ratio for VTE increased with the IgG titer: the adjusted odds ratios were 2.1 (95% CI, 1.1-4.1), 5.3 (2.7-10.6) and 33.0 (4.4-248.4) for titers of 256, 512 and 1024, respectively. Only one subject (a case patient) with a high IgG titer (≥256) also had specific IgM. High titers of anti-C. pneumoniae IgG antibodies are frequently found in patients with previous venous thromboembolism. This association deserves to be confirmed in other case-control studies and prospective studies.All authors have reviewed the manuscript and agree with its content.
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14
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Grésenguet G, Longo JDD, Tonen-Wolyec S, Mboumba Bouassa RS, Belec L. Acceptability and Usability Evaluation of Finger-Stick Whole Blood HIV Self-Test as An HIV Screening Tool Adapted to The General Public in The Central African Republic. Open AIDS J 2017; 11:101-118. [PMID: 29290887 PMCID: PMC5730956 DOI: 10.2174/1874613601711010101] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 09/27/2017] [Accepted: 10/31/2017] [Indexed: 11/24/2022] Open
Abstract
Background: Opportunities for HIV testing could be enhanced by offering HIV self-testing (HIVST) in populations that fear stigma and discrimination when accessing conventional HIV counselling and testing. Field experience with HIVST was poorly reported in French-speaking African countries. Objective: To investigate the usability of HIVST in Bangui, Central African Republic. Methods: The prototype self-test Exacto® Test HIV (Biosynex, Strasbourg, France) was used to assess the usability of HIVST in 300 adults living in Bangui, according to WHO technical recommendations. Simplified and easy-to-read leaflet was translated in French and Sango. Results: Preliminary survey in 3,484 adult volunteers including students, men who have sex with men and female sex workers living in Bangui showed that previous HIV testing in conventional centres for HIV counselling and testing was relatively infrequent and that acceptability of HIVST was elevated, although high heterogeneity could be observed between groups. The notice in French and Sango of Exacto® Test HIV were chosen in 242/300 (80.6%) and 58/300 (19.4%), respectively. It was correctly understood in 273/300 (91.0%). The majority (275/300; 91.6%) correctly performed the HIV self-test; however, 71/300 (23.0%) asked for oral assistance. Most of the participants (273/300; 91.0%) found that performing of the self-test was very easy or easy, and less than Most of participants (273/300; 91.0%) found that performing of the self-test was very easy or easy and less than 1.0% (2/300) found it difficult. Overall the result were correctly interpreted in 96.9% (3,782/3,900), the reading/interpretion errors concerned the positive (96/1,800;5.3%), invalid (17/600;2.8%) and negative (5/1,500; 0.3%) self-test. The Cohen's coefficient κwas 0.94. The main obstacle for HIVST was the educational level, with interpretation difficulties in poorly educated people. Conclusions: Our observations on profane adults living in Central African Republic, demonstrate: (i) the need to adapt the notice of instruction to African public, including educational pictograms as well as notice in vernacular language(s); (ii) the frequent difficulties in understanding the notice with frequent misinterpretation of test results; (iii) and the generally good usability of the HIV self-test despite these latter pitfalls. More research on exploring the best strategy (i.e. supervised versus unsupervised strategies) for different high- and low- risk populations in resource-constrained settings remains needed.
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Affiliation(s)
- Gérard Grésenguet
- Centre National de Référence des Maladies Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic.,Faculté de Médecine et de Pharmacie, Université de Bunia and Université de Kisangani, Democratic Republic of Congo
| | - Jean de Dieu Longo
- Centre National de Référence des Maladies Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic.,Faculté de Médecine et de Pharmacie, Université de Bunia and Université de Kisangani, Democratic Republic of Congo
| | - Serge Tonen-Wolyec
- Faculté de Médecine et de Pharmacie, Université de Bunia and Université de Kisangani, Democratic Republic of Congo
| | - Ralph-Sydney Mboumba Bouassa
- Laboratoire de Microbiologie, hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, and Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Laurent Belec
- Laboratoire de Microbiologie, hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, and Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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Longo JDD, Simaleko MM, Diemer HSC, Grésenguet G, Brücker G, Belec L. Risk factors for HIV infection among female sex workers in Bangui, Central African Republic. PLoS One 2017; 12:e0187654. [PMID: 29108022 PMCID: PMC5673229 DOI: 10.1371/journal.pone.0187654] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 10/24/2017] [Indexed: 02/06/2023] Open
Abstract
Objective The aims of the study were i) to categorize female sex workers (FSW) according to socio-anthropologic criteria in Bangui; ii) to examine the association between a selection of demographic and risk variables with the different categories of female sex work as outcome, and iii) to investigate factors associated with HIV status. Methods A cross-sectional questionnaire survey was conducted to describe the spectrum of commercial sex work in Bangui among 345 sexually active women. After collection of social and behavioral characteristics, each woman received a physical examination and a blood sample was taken for biological analyses, including HIV testing. The relationships between sociodemographic characteristics, behavioral variables involved in high risk for HIV as well as biological results were investigated by bivariate analysis in relationship with FSW categories as main outcomes, and by bivariate analysis followed by multivariate logistic regression analysis in relationship with HIV as the main outcome. The strength of statistical associations was measured by crude and adjusted Odds ratios (OR) and their 95% confidence intervals. Results The typology of FSW comprised six different categories. Two groups were the “official” professional FSW primarily classified according to their locations of work [i) “kata“(18.55%) representing women working in poor neighborhoods of Bangui; ii) “pupulenge” (13.91%) working in hotels and night clubs to seek white men]. Four groups were “clandestine” nonprofessional FSW classified according to their reported main activity [i) “market and street vendors” (20.86%); ii) “schoolgirls or students” (19.13%) involved in occasional transactional sex (during holidays); iii) “housewives or unemployed women” (15.65%); iv) “civil servants” (11.88%) working as soldiers or in the public sector]. The overall prevalence of HIV-1 was 19.12% (66/345). HIV varied according to FSW categories. Thus, among professional FSW, the HIV prevalence was 6-fold higher in "kata" than "pupulenge" (39.13% versus 6.30%; P = 0.001). Among nonprofessional FSW, the "vendors" showed the highest HIV prevalence (31.91%), which was higher than in "students" (6.10%; P = 0.001), "civil servants" (9.83%; P = 0.005), and "housewives" (13.00%; P = 0.01). In bivariate analysis, the following variables showed statistically significant association with risk for HIV infection: nationality; age of first sexual intercourse; self-assessment of HIV risk; knowledge of HIV status; anal sex practice with last clients; irregular condom use in last week; consumption of alcohol; other psycho-active substances; past history of STIs; HBs Ag; HSV-2 and bacterial vaginosis. However, the variable “sex workers categories” dichotomized into professional versus nonprofessional FSW was no longer associated with HIV. In multivariate logistical regression analysis, HIV infection was strongly associated with nationality (15.65% versus 3.77%) [adjusted OR (aOR) 3.39: 95% CI:1.25–9.16, P<0.05]; age of first sexual intercourse (21.10% versus 14.00%) (aOR 2.13: 95% CI: 1.03–4.39, P<0.05); anal sex practice with last clients (43.40% versus 11.50%) (aOR 4.31: 95% CI:2.28–8.33, P<0.001); irregular condom use in past week (33.50% versus 3.00%) (aOR 5.49: 95% CI:1.89–15.98, P<0.001); alcohol consumption before sex (34.70% versus 7.80%) (aOR 2.69: 95% CI:1.22–4.96, P<0.05); past history of STIs (41.00% versus 10.80%) (aOR 2.46: 95% CI:1.22–4.97, P<0.05) and bacterial vaginosis (29.80% versus 4.29%) (aOR 6.36: 95% CI: 2.30–17.72, P<0.001). Conclusion Our observations highlight the high level of vulnerability for HIV acquisition of both poor professional “kata” and nonprofessional “street vendor” FSW categories. These categories should be particularly taken into account when designing specific prevention programs for STIs/HIV control purposes.
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Affiliation(s)
- Jean De Dieu Longo
- Centre National de Référence des Maladies Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
- Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et le SIDA, Département de Santé Publique, Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
- * E-mail:
| | - Marcel Mbeko Simaleko
- Centre National de Référence des Maladies Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
| | - Henri Saint-Calvaire Diemer
- Centre National de Référence des Maladies Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
| | - Gérard Grésenguet
- Centre National de Référence des Maladies Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
- Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et le SIDA, Département de Santé Publique, Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
| | - Gilles Brücker
- Université Paris Sud, Département de Santé Publique, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
- Direction Internationale, Assistance Publique-Hôpitaux de Paris, Paris, Franc
| | - Laurent Belec
- Laboratoire de Microbiologie, hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
- Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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Mossoro-Kpinde CD, Jenabian MA, Gody JC, Robin L, Talla P, Longo J, Grésenguet G, Belec L. Evaluation of the Upgraded Version 2.0 of the Roche COBAS ® AmpliPrep/COBAS ® TaqMan HIV-1 Qualitative Assay in Central African Children. Open AIDS J 2016; 10:158-163. [PMID: 27857825 PMCID: PMC5091015 DOI: 10.2174/1874613601610010158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 05/03/2016] [Accepted: 05/30/2016] [Indexed: 11/22/2022] Open
Abstract
Background: Several commercially available molecular techniques were developed based on subtype B of HIV-1, which represents only 10% of HIV strains worldwide. Indeed, in sub-Saharan Africa, non-B subtypes of HIV-1 are predominant. The aim of this study was to evaluate the performances of the COBAS® AmpliPrep/COBAS® (CAP/CTM) HIV-1 Qualitative assays to detect the broad range of HIV-1 variants circulating in Central Africa and compare to the outgoing CAP/CTM HIV-1 Quantitative test v2.0 (Roche Molecular Systems), chosen as reference gold standard molecular assay. Methods: The CAP/CTM HIV-1 Qualitative tests versions 1.0 and 2.0 (Roche Molecular Systems, Inc., Branchburg, NJ, USA) were evaluated compared to CAP/CTM TaqMan HIV-1 Quantitative test v2.0 (Roche Molecular Systems) on 239 dried plasma spot (DPS) from 133 HIV-1-infected (with detectable plasma HIV RNA load) and 106 uninfected children, followed-up at Complexe Pédiatrique, Bangui, Central African Republic. Results: The version 1.0 showed low sensitivity (93.2%), with 9 (6.8%) false negative results, demonstrating under-detection of non-B HIV-1 subtypes. In contrast, the upgraded version 2.0 showed 100%-sensitivity, 100%-specificity and perfect agreement (κ coefficient, 1.0). Conclusion: Our evaluation in the Central African Republic demonstrates the clinical implications of the accuracy and reliability of the CAP/CTM HIV-1 Qualitative assay for early diagnosis of HIV-1 in Central African children.
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Affiliation(s)
- C D Mossoro-Kpinde
- Laboratoire National de Biologie Clinique et de Santé Publique, Bangui, Central African Republic; Faculté des Sciences de la Santé, Université de Bangui, Bangui, Central African Republic
| | - M A Jenabian
- Department of Biological Sciences and BioMed Research Center, Université du Québec ā Montréal (UQAM), Montreal, Canada
| | - J C Gody
- Faculté des Sciences de la Santé, Université de Bangui, Bangui, Central African Republic; Complexe Pédiatrique, Bangui, Central African Republic
| | - L Robin
- Laboratoire de virologie, hôpital Européen Georges Pompidou, and Université Paris Descartes, Paris Sorbonne Cité, Paris, France
| | - P Talla
- Laboratoire de virologie, hôpital Européen Georges Pompidou, and Université Paris Descartes, Paris Sorbonne Cité, Paris, France
| | - Jdd Longo
- Faculté des Sciences de la Santé, Université de Bangui, Bangui, Central African Republic
| | - G Grésenguet
- Faculté des Sciences de la Santé, Université de Bangui, Bangui, Central African Republic
| | - L Belec
- Laboratoire de virologie, hôpital Européen Georges Pompidou, and Université Paris Descartes, Paris Sorbonne Cité, Paris, France
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Longo JDD, Rasacanu A, Mbopi-Keou FX, Gresenguet G, Belec L. Atypical extensive genital ulcer in full blown aids with slim disease. Afr J Infect Dis 2015. [DOI: 10.4314/ajid.v10i1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Longo JDD, Rasacanu A, Mbopi-Keou FX, Gresenguet G, Belec L. A TYPICAL EXTENSIVE GENITAL ULCER IN FULL BLOWN AIDS WITH SLIM DISEASE. Afr J Infect Dis 2015. [DOI: 10.21010/ajid.v10i1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Tang MW, Rhee SY, Bertagnolio S, Ford N, Holmes S, Sigaloff KC, Hamers RL, de Wit TFR, Fleury HJ, Kanki PJ, Ruxrungtham K, Hawkins CA, Wallis CL, Stevens W, van Zyl GU, Manosuthi W, Hosseinipour MC, Ngo-Giang-Huong N, Belec L, Peeters M, Aghokeng A, Bunupuradah T, Burda S, Cane P, Cappelli G, Charpentier C, Dagnra AY, Deshpande AK, El-Katib Z, Eshleman SH, Fokam J, Gody JC, Katzenstein D, Koyalta DD, Kumwenda JJ, Lallemant M, Lynen L, Marconi VC, Margot NA, Moussa S, Ndung'u T, Nyambi PN, Orrell C, Schapiro JM, Schuurman R, Sirivichayakul S, Smith D, Zolfo M, Jordan MR, Shafer RW. Nucleoside reverse transcriptase inhibitor resistance mutations associated with first-line stavudine-containing antiretroviral therapy: programmatic implications for countries phasing out stavudine. J Infect Dis 2013; 207 Suppl 2:S70-7. [PMID: 23687292 DOI: 10.1093/infdis/jit114] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The World Health Organization Antiretroviral Treatment Guidelines recommend phasing-out stavudine because of its risk of long-term toxicity. There are two mutational pathways of stavudine resistance with different implications for zidovudine and tenofovir cross-resistance, the primary candidates for replacing stavudine. However, because resistance testing is rarely available in resource-limited settings, it is critical to identify the cross-resistance patterns associated with first-line stavudine failure. METHODS We analyzed HIV-1 resistance mutations following first-line stavudine failure from 35 publications comprising 1,825 individuals. We also assessed the influence of concomitant nevirapine vs. efavirenz, therapy duration, and HIV-1 subtype on the proportions of mutations associated with zidovudine vs. tenofovir cross-resistance. RESULTS Mutations with preferential zidovudine activity, K65R or K70E, occurred in 5.3% of individuals. Mutations with preferential tenofovir activity, ≥ two thymidine analog mutations (TAMs) or Q151M, occurred in 22% of individuals. Nevirapine increased the risk of TAMs, K65R, and Q151M. Longer therapy increased the risk of TAMs and Q151M but not K65R. Subtype C and CRF01_AE increased the risk of K65R, but only CRF01_AE increased the risk of K65R without Q151M. CONCLUSIONS Regardless of concomitant nevirapine vs. efavirenz, therapy duration, or subtype, tenofovir was more likely than zidovudine to retain antiviral activity following first-line d4T therapy.
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Affiliation(s)
- Michele W Tang
- Division Infectious Diseases, Department of Medicine, Stanford University, California 94305, USA.
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Todd J, Riedner G, Maboko L, Hoelscher M, Weiss HA, Lyamuya E, Mabey D, Rusizoka M, Belec L, Hayes R. Effect of genital herpes on cervicovaginal HIV shedding in women co-infected with HIV AND HSV-2 in Tanzania. PLoS One 2013; 8:e59037. [PMID: 23516595 PMCID: PMC3596319 DOI: 10.1371/journal.pone.0059037] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 02/11/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To compare the presence and quantity of cervicovaginal HIV among HIV seropositive women with clinical herpes, subclinical HSV-2 infection and without HSV-2 infection respectively; to evaluate the association between cervicovaginal HIV and HSV shedding; and identify factors associated with quantity of cervicovaginal HIV. DESIGN Four groups of HIV seropositive adult female barworkers were identified and examined at three-monthly intervals between October 2000 and March 2003 in Mbeya, Tanzania: (1) 57 women at 70 clinic visits with clinical genital herpes; (2) 39 of the same women at 46 clinic visits when asymptomatic; (3) 55 HSV-2 seropositive women at 60 clinic visits who were never observed with herpetic lesions; (4) 18 HSV-2 seronegative women at 45 clinic visits. Associations of genital HIV shedding with HIV plasma viral load (PVL), herpetic lesions, HSV shedding and other factors were examined. RESULTS Prevalence of detectable genital HIV RNA varied from 73% in HSV-2 seronegative women to 94% in women with herpetic lesions (geometric means 1634 vs 3339 copies/ml, p = 0.03). In paired specimens from HSV-2 positive women, genital HIV viral shedding was similar during symptomatic and asymptomatic visits. On multivariate regression, genital HIV RNA (log10 copies/mL) was closely associated with HIV PVL (β = 0.51 per log10 copies/ml increase, 95%CI:0.41-0.60, p<0.001) and HSV shedding (β = 0.24 per log10 copies/ml increase, 95% CI:0.16-0.32, p<0.001) but not the presence of herpetic lesions (β = -0.10, 95%CI:-0.28-0.08, p = 0.27). CONCLUSIONS HIV PVL and HSV shedding were more important determinants of genital HIV than the presence of herpetic lesions. These data support a role of HSV-2 infection in enhancing HIV transmissibility.
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Affiliation(s)
- Jim Todd
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
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Belec L, Trotot P, Lescs MC, Gray F. Lésions précoces du système nerveux central au cours de l'infection par le virus de l'immunodéficience humaine. Med Sci (Paris) 2013. [DOI: 10.4267/10608/3061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kebe K, Thiam M, Diagne Gueye NR, Diop H, Dia A, Signate Sy H, Charpentier C, Belec L, Mboup S, Toure Kane C. High rate of antiretroviral drug resistance mutations in HIV type 1-infected Senegalese children in virological failure on first-line treatment according to the World Health Organization guidelines. AIDS Res Hum Retroviruses 2013; 29:242-9. [PMID: 22860571 DOI: 10.1089/aid.2011.0300] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The rates of virological failure (VF) and HIV-1 drug resistance were evaluated in a cross-sectional study in HIV-1-infected children living in Dakar, and taking antiretroviral treatment (ART) according to WHO recommendations. The plasma HIV-1 RNA load was measured using the Abbott m2000 RealTime HIV-1 assay. The full-length protease gene and partial reverse transcriptase gene were sequenced, and resistance mutations were assessed by reference to the Stanford University HIV drug resistance database. Of 125 included children (median age, 7 years) taking first-line ART for a median duration of 20 months, 82 (66%) showed detectable HIV-1 RNA load, and 70 (56%) met the 2010 revised WHO criteria of VF (defined as plasma HIV-1 RNA load ≥3.7 log(10) copies/ml). Drug resistance results were available for 52 children with plasma HIV-1 RNA load ≥3.0 log(10) copies/ml, and viruses carrying resistance mutations were found in 48 (92%) children. Among these 48, mutations conferring resistance to nucleoside reverse transcriptase inhibitors (NRTIs) or non-NRTIs (NNRTIs) were found in 42 (88%) and 47 (99%) children, respectively. The NRTI-resistant viruses harbored the M184V/I (95%), Q151M (2%), and thymidine-analogue mutations (40%), and the NNRTI-resistant viruses harbored the K103N (34%), Y181C (32%), G190A (23%), and K101E (21%) mutations. A high rate (56%) of VF was demonstrated in Senegalese children after 20 months of first-line ART and therapeutic failure was assessed by the presence of antiretroviral drug resistance mutations in 9 out of 10 children in VF. These findings point out the difficulties of optimizing ART in children living in sub-Saharan Africa, and the crucial need of laboratory monitoring reinforcement.
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Affiliation(s)
- Khady Kebe
- Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal
| | - Moussa Thiam
- Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal
| | | | - Halimatou Diop
- Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal
| | | | | | - Charlotte Charpentier
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Laboratoire de Virologie, and Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Laurent Belec
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Laboratoire de Virologie, and Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Souleymane Mboup
- Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal
| | - Coumba Toure Kane
- Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal
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Saidi H, Jenabian MA, Belec L. Understanding factors that modulate HIV infection at the female genital tract mucosae for the rationale design of microbicides. AIDS Res Hum Retroviruses 2012; 28:1485-97. [PMID: 22867060 DOI: 10.1089/aid.2012.0049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Women are now becoming the pivot of the epidemiological spread of HIV infection worldwide, especially in developing countries. Therefore, research to develop an efficient microbicide is now a priority for the prevention of HIV-1 acquisition in exposed women. However, recent disappointing failures in microbicide clinical trials revealed major gaps in basic and applied knowledge that hinder the development of effective microbicide formulations. Indeed, the inhibitory power of microbicide molecules may be affected by several physiological and immunological factors present in male and female genital tracts. Furthermore, mucosal crossing of HIV-1 to increase the ability to reach the submucosal target cells (macrophages, lymphocytes, and dendritic cells) may be modulated by supraepithelial factors such as seminal complement components (opsonized HIV-1), by epithelial factors released in the submucosal microenvironment such as antimicrobial soluble factors, cytokines, and chemokines, and by potent intraepithelial and submucosal innate immunity. The design of vaginal microbicide formulations should take into account an understanding of the intimate mechanisms involved in the crossing of HIV through the female genital mucosae, in the context of a mixture of both male and female genital fluids.
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Affiliation(s)
- Hela Saidi
- Division of Immuno-Virology, Institute of Emerging Diseases and Innovative Therapies, Commissariat à l'Energie Atomique, Fontenay-aux-Roses, France
| | - Mohammad-Ali Jenabian
- Chronic Viral Illnesses Service of the McGill University Health Centre, and Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Laurent Belec
- Assistance Publique–Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Laboratoire de Virologie, and Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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Weiss HA, Paz Bailey G, Phiri S, Gresenguet G, LeGoff J, Pepin J, Lewis DA, Belec L, Hoffman IF, Miller WC, Mayaud P. Episodic therapy for genital herpes in sub-saharan Africa: a pooled analysis from three randomized controlled trials. PLoS One 2011; 6:e22601. [PMID: 21799914 PMCID: PMC3143155 DOI: 10.1371/journal.pone.0022601] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2011] [Accepted: 06/25/2011] [Indexed: 11/19/2022] Open
Abstract
Background A randomized controlled trial in South Africa found a beneficial effect of acyclovir on genital ulcer healing, but no effect was seen in trials in Ghana, Central African Republic and Malawi. The aim of this paper is to assess whether the variation in impact of acyclovir on ulcer healing in these trials can be explained by differences in the characteristics of the study populations. Methodology/Principal Findings Pooled data were analysed to estimate the impact of acyclovir on the proportion of ulcers healed seven days after randomisation by HIV/CD4 status, ulcer aetiology, size and duration before presentation; and impact on lesional HIV-1. Risk ratios (RR) were estimated using Poisson regression with robust standard errors. Of 1478 patients with genital ulcer, most (63%) had herpetic ulcers (16% first episode HSV-2 ulcers), and a further 3% chancroid, 2% syphilis, 0.7% lymphogranuloma venereum and 31% undetermined aetiology. Over half (58%) of patients were HIV-1 seropositive. The median duration of symptoms before presentation was 6 days. Patients on acyclovir were more likely to have a healed ulcer on day 7 (63% vs 57%, RR = 1.08, 95% CI 0.98–1.18), shorter time to healing (p = 0.04) and less lesional HIV-1 RNA (p = 0.03). Small ulcers (<50 mm2), HSV-2 ulcers, first episode HSV-2 ulcers, and ulcers in HIV-1 seropositive individuals responded best but the better effectiveness in South Africa was not explained by differences in these factors. Conclusions/Significance There may be slight benefit in adding acyclovir to syndromic management in settings where most ulcers are genital herpes. The stronger effect among HIV-1 infected individuals suggests that acyclovir may be beneficial for GUD/HIV-1 co-infected patients. The high prevalence in this population highlights that genital ulceration in patients with unknown HIV status provides a potential entry point for provider-initiated HIV testing.
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Affiliation(s)
- Helen A Weiss
- London School of Hygiene and Tropical Medicine, London, United Kingdom.
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Tanton C, Weiss HA, LeGoff J, Changalucha J, Clayton TC, Ross DA, Belec L, Hayes RJ, Watson-Jones D. Patterns of herpes simplex virus shedding over 1 month and the impact of acyclovir and HIV in HSV-2-seropositive women in Tanzania. Sex Transm Infect 2011; 87:406-11. [PMID: 21653932 PMCID: PMC3273761 DOI: 10.1136/sti.2010.048496] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives Few studies have examined the frequency and duration of genital herpes simplex virus (HSV) shedding in sub-Saharan Africa. This study describes HSV shedding patterns among a sample of HSV-2-seropositive women enrolled in a placebo-controlled trial of HSV suppressive therapy (acyclovir 400 mg twice a day) in Tanzania. Methods Trial participants were invited to participate in a substudy involving 12 clinic visits over 4 weeks. At each visit, cervical, vaginal and external skin swabs were taken and analysed for HSV DNA using inhouse real-time PCR. Results HSV shedding was mainly subclinical (90%; 57/63 shedding days in the placebo arm). The most frequent shedding site was the external skin, but HSV DNA was detected from all three sites on 42% (27/63) of shedding days. In HIV-negative women, HSV DNA was detected on 3% (9/275) of days in the acyclovir versus 11% (33/309) in the placebo arm, while in HIV-positive women, detection was on 14% (23/160) versus 19% (30/155) of days, respectively. Conclusions HSV shedding was common, varying greatly by individual. Shedding rates were similar to studies in African and non-African settings. Among HIV-negative women, shedding rates were lower in the acyclovir arm; however, acyclovir did not substantially impact on HSV shedding in HIV-positive women.
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Affiliation(s)
- Clare Tanton
- Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, Mortimer Market Centre, off Capper Street, London WC1E 6JB, UK.
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Carthagena L, Becquart P, Hocini H, Kazatchkine MD, Bouhlal H, Belec L. Modulation of HIV Binding to Epithelial Cells and HIV Transfer from Immature Dendritic Cells to CD4 T Lymphocytes by Human Lactoferrin and its Major Exposed LF-33 Peptide. Open Virol J 2011; 5:27-34. [PMID: 21660187 PMCID: PMC3109640 DOI: 10.2174/1874357901105010027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 02/14/2011] [Accepted: 03/02/2011] [Indexed: 11/22/2022] Open
Abstract
Lactoferrin (LF), a multifunctional molecule present in human secretions, has potent inhibitory activities against human immunodeficiency virus (HIV). The aim of the study was to evaluate whether human LF (hLF) and its exposed domain LF-33 represented by the peptide (LF-33-GRRRRSVQWCAVSQPEATKCFQWQRNMRKVRGP) involved in LF-HIV gag binding and endotoxines neutralization, may inhibit early steps of HIV mucosal transmission. Human LF and the peptide LF-33 inhibited the attachment of primary X4-tropic HIV-1(NDK) and R5-tropic HIV-1(JR-CSF) strains to human endometrial (HEC-1) and colorectal (HT-29) CD4-negative epithelial cells, the purified hLF being more potent (up to 80%) than the LF-33 peptide. In addition, the hLF, but not the LF-33 peptide, inhibited up to 40% the transfer in trans of HIV-1(JR-CSF) and HIV-1(NDK,) from immature dendritic cells to CD4 T lymphocytes, likely in a DC-SIGN-dependent manner. Altogether, these findings demonstrate that hLF can interfere with HIV-1 mucosal transmission by blocking virus attachment to epithelial cells and by inhibiting virus transfer from dendritic cells to CD4 T cells, two crucial steps of HIV dissemination from mucosae to lymphoid tissue.
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Tanton C, Weiss HA, Le Goff J, Changalucha J, Rusizoka M, Baisley K, Everett D, Ross DA, Belec L, Hayes RJ, Watson-Jones D. Correlates of HIV-1 genital shedding in Tanzanian women. PLoS One 2011; 6:e17480. [PMID: 21390251 PMCID: PMC3046975 DOI: 10.1371/journal.pone.0017480] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 02/05/2011] [Indexed: 11/18/2022] Open
Abstract
Background Understanding the correlates of HIV shedding is important to inform strategies to reduce HIV infectiousness. We examined correlates of genital HIV-1 RNA in women who were seropositive for both herpes simplex virus (HSV)-2 and HIV-1 and who were enrolled in a randomised controlled trial of HSV suppressive therapy (aciclovir 400 mg b.i.d vs. placebo) in Tanzania. Methodology Samples, including a cervico-vaginal lavage, were collected and tested for genital HIV-1 and HSV and reproductive tract infections (RTIs) at randomisation and 6, 12 and 24 months follow-up. Data from all women at randomisation and women in the placebo arm during follow-up were analysed using generalised estimating equations to determine the correlates of cervico-vaginal HIV-1 RNA detection and load. Principal Findings Cervico-vaginal HIV-1 RNA was detected at 52.0% of 971 visits among 482 women, and was independently associated with plasma viral load, presence of genital ulcers, pregnancy, bloody cervical or vaginal discharge, abnormal vaginal discharge, cervical ectopy, Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, an intermediate bacterial vaginosis score and HSV DNA detection. Similar factors were associated with genital HIV-1 RNA load. Conclusions RTIs were associated with increased presence and quantity of genital HIV-1 RNA in this population. These results highlight the importance of integrating effective RTI treatment into HIV care services.
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Affiliation(s)
- Clare Tanton
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
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Tanton C, Weiss HA, Rusizoka M, Legoff J, Changalucha J, Baisley K, Mugeye K, Everett D, Belec L, Clayton TC, Ross DA, Hayes RJ, Watson-Jones D. Long-term impact of acyclovir suppressive therapy on genital and plasma HIV RNA in Tanzanian women: a randomized controlled trial. J Infect Dis 2010; 201:1285-97. [PMID: 20235836 DOI: 10.1086/651696] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Herpes simplex virus (HSV) suppressive therapy reduces genital and plasma human immunodeficiency virus type 1 (HIV-1) RNA over periods up to 3 months, but the long-term effect is unknown. METHODS A total of 484 HIV-1 and HSV type 2 seropositive Tanzanian women aged 16-35 years were enrolled in a randomized placebo-controlled trial of acyclovir administered at a dosage of 400 mg twice daily. Cervico-vaginal lavage and blood samples were collected at 6 months, 12 months, and 24 months for quantification of genital and plasma HIV-1 RNA and genital HSV DNA. Primary outcomes were detection and quantity of cervico-vaginal HIV-1 RNA at 6 months. RESULTS At 6 months, there was little difference between the acyclovir and placebo arms for cervico-vaginal HIV-1 RNA detection (88 [ 41 .3%] of 213 vs 84 [ 44 .0%] of 191; odds ratio [OR], 0.90; 95% confidence interval [CI], 0.60-1.33), HSV DNA detection (20 [ 9 .4%] of 213 vs 22 [ 11 .5%] of 191; OR, 0.80; 95% CI, 0.42-1.51), genital HIV or HSV loads, or plasma HIV-1 RNA load. Estimated median adherence was 91%. There was a suggestion of an impact on cervico-vaginal HIV-1 RNA detection among women with estimated adherence 90% (OR, 0.74; 95% CI, 0.50-1.09) when data from all 3 visits were included. CONCLUSIONS Acyclovir administered at a dosage of 400 mg twice daily is unlikely to be a useful long-term intervention to reduce HIV transmission. The lack of effect on HIV may be attributable to suboptimal adherence or treatment regimen.
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Affiliation(s)
- Clare Tanton
- London School of Hygiene and Tropical Medicine, London, United Kingdom.
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Kane CT, Diawara S, Ndiaye HD, Diallo PAN, Wade AS, Diallo AG, Belec L, Mboup S. Concentrated and linked epidemics of both HSV-2 and HIV-1/HIV-2 infections in Senegal: public health impacts of the spread of HIV. Int J STD AIDS 2009; 20:793-6. [DOI: 10.1258/ijsa.2008.008414] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective of this article is to report seroprevalences on HIV and herpes simplex virus 2 (HSV-2) in female sex workers (FSW) and in two sentinel populations of pregnant women living in Senegal. Serosurveys of HIV and HSV-2 were conducted in two unselected sentinel populations from Dakar, Senegal, and its provinces, including in 2003 only pregnant women and 2006 pregnant women and FSW. The population study involved 888 pregnant women and 604 FSW. In pregnant women, HIV and HSV-2 seroprevalences were, respectively, 1.01% and 15.65%. There was no association between HSV-2 and HIV infection, whatever the age. In contrast, the seroprevalence of HIV infection in the group of FSW was high, reaching 22.9% in women over 30 years old. FSW above 20 years of age harboured much higher HSV-2 seroprevalences that those found in pregnant women of similar age groups. In FSW, strong associations between HSV-2 and age, and among HSV-2 and HIV-1 as well HIV-2, were evidenced. In conclusion, HIV epidemic remains concentrated in high-risk groups of the Senegalese population, such as the FSW population in which the seroprevalence of HSV-2 infection is very high. Intervention against STI including HSV-2 is urgently needed to prevent the spreading of HIV epidemic.
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Affiliation(s)
- C Toure Kane
- Laboratoire de Bacteriologie-virologie, Hopital Aristide Le Dantec
| | - S Diawara
- Hopital Militaire de Ouakam, Dakar, Senegal
| | - H D Ndiaye
- Laboratoire de Bacteriologie-virologie, Hopital Aristide Le Dantec
| | - P A N Diallo
- Laboratoire de Bacteriologie-virologie, Hopital Aristide Le Dantec
| | - A S Wade
- Ministry of Health, Division against AIDS/STIs, Senegal
| | - A G Diallo
- Laboratoire de Bacteriologie-virologie, Hopital Aristide Le Dantec
| | - L Belec
- Université Paris Descartes (Paris V), Laboratoire de Virologie, Hopital Européen Georges Pompidou, Paris, France
| | - S Mboup
- Laboratoire de Bacteriologie-virologie, Hopital Aristide Le Dantec
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Saïdi H, Magri G, Carbonneil C, Bouhlal H, Hocini H, Belec L. Apical interactions of HIV type 1 with polarized HEC-1 cell monolayer modulate R5-HIV type 1 spread by submucosal macrophages. AIDS Res Hum Retroviruses 2009; 25:497-509. [PMID: 19397398 DOI: 10.1089/aid.2008.0156] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The in vitro model of HIV-1 transcytosis through a monolayer of HEC-1 cells is thought to mimic the mucosal crossing of the virus that may occur in vivo. We evaluated whether the stimulation of HEC-1 by HIV may modulate HIV infection of macrophages. Thus, the ability to capture, produce, and transfer R5 viruses to T cells, attract T cells, and finally produce cytokines/chemokines, was compared between untreated macrophages (M0) and macrophages differentiated in the presence of medium collected at the basolateral pole of HEC-1, which were unstimulated [M(BL)] or stimulated with either R5-HIV-1Ba-L [M(BL-R5)] or X4-HIV-1NDK [M(BL-X4)]. M(BL-X4)-secreted CCR5-interacting chemokines integrated and replicated HIV less efficiently than did M(BL) and M(BL-R5). M(BL-R5) and M(BL-X4) similarly transmitted HIV to activated T cells. Interestingly, mannose-binding receptors and heparan sulfate proteoglycans were variously involved in HIV adsorption, whereas DC-SIGN mostly mediated the HIV transfer. Conversely to M(BL) and M(BL-X4), M(BL-R5) did not secrete eotaxin, GRO, ITAC, lymphotactin, MIP-1, MIP-3, and RANTES, which was associated with a weak capacity to recruit CD4(+)CXCR4(+)CCR5(+) T cells. In particular, M(BL-R5) specifically released soluble factors enhancing HIV production by recruited T cells. These submucosal-conditioned macrophages differentially captured, produced, and transferred R5-HIV-1 to T cells, according to the tropism of the virus deposited at the apical pole of HEC-1. These observations challenge the question of the in vivo involvement of HIV-1 as a supraepithelial stimulus that likely modulates the susceptibility for HIV-1 of submucosal target cells in favor of its transmission.
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Affiliation(s)
- Héla Saïdi
- Université Paris Descartes (Paris V), Unité INSERM U743 “Immunologie Humaine,” Equipe “Immunité et Biothérapie Muqueuse,” Centre de Recherches Biomédicales des Cordeliers, Paris, France
- Institut Pasteur, Antiviral Immunity, Biotherapy, and Vaccine Unit, Infection and Epidemiology Department, Paris, France
| | - Giuliana Magri
- Université Paris Descartes (Paris V), Unité INSERM U743 “Immunologie Humaine,” Equipe “Immunité et Biothérapie Muqueuse,” Centre de Recherches Biomédicales des Cordeliers, Paris, France
| | - Cédric Carbonneil
- Université Paris Descartes (Paris V), Unité INSERM U743 “Immunologie Humaine,” Equipe “Immunité et Biothérapie Muqueuse,” Centre de Recherches Biomédicales des Cordeliers, Paris, France
| | - Hicham Bouhlal
- Université Paris Descartes (Paris V), Unité INSERM U743 “Immunologie Humaine,” Equipe “Immunité et Biothérapie Muqueuse,” Centre de Recherches Biomédicales des Cordeliers, Paris, France
- Institut Pasteur, Antiviral Immunity, Biotherapy, and Vaccine Unit, Infection and Epidemiology Department, Paris, France
- Unité Inserm 4925, Laboratoire d'Immunologie, Université Picardie Jules Verne, Amiens, France
| | - Hakim Hocini
- Université Paris Descartes (Paris V), Unité INSERM U743 “Immunologie Humaine,” Equipe “Immunité et Biothérapie Muqueuse,” Centre de Recherches Biomédicales des Cordeliers, Paris, France
| | - Laurent Belec
- Université Paris Descartes (Paris V), Unité INSERM U743 “Immunologie Humaine,” Equipe “Immunité et Biothérapie Muqueuse,” Centre de Recherches Biomédicales des Cordeliers, Paris, France
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Billot X, Marcellus R, Belec L, Trempe J, Safaee N, Gehring K, Schrag J, Cygler M, Lawless M, Beauparlant P. 134 POSTER The rational design of inhibitors of the telomere-hnRNP A1 interaction. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)72066-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Fichorova RN, Richardson-Harman N, Alfano M, Belec L, Carbonneil C, Chen S, Cosentino L, Curtis K, Dezzutti CS, Donoval B, Doncel GF, Donaghay M, Grivel JC, Guzman E, Hayes M, Herold B, Hillier S, Lackman-Smith C, Landay A, Margolis L, Mayer KH, Pasicznyk JM, Pallansch-Cokonis M, Poli G, Reichelderfer P, Roberts P, Rodriguez I, Saidi H, Sassi RR, Shattock R, Cummins JE. Biological and technical variables affecting immunoassay recovery of cytokines from human serum and simulated vaginal fluid: a multicenter study. Anal Chem 2008; 80:4741-51. [PMID: 18484740 PMCID: PMC2646866 DOI: 10.1021/ac702628q] [Citation(s) in RCA: 148] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The increase of proinflammatory cytokines in vaginal secretions may serve as a surrogate marker of unwanted inflammatory reaction to microbicide products topically applied for the prevention of sexually transmitted diseases, including HIV-1. Interleukin (IL)-1beta and IL-6 have been proposed as indicators of inflammation and increased risk of HIV-1 transmission; however, the lack of information regarding detection platforms optimal for vaginal fluids and interlaboratory variation limit their use for microbicide evaluation and other clinical applications. This study examines fluid matrix variants relevant to vaginal sampling techniques and proposes a model for interlaboratory comparisons across current cytokine detection technologies. IL-1beta and IL-6 standards were measured by 12 laboratories in four countries, using 14 immunoassays and four detection platforms based on absorbance, chemiluminescence, electrochemiluminescence, and fluorescence. International reference preparations of cytokines with defined biological activity were spiked into (1) a defined medium simulating the composition of human vaginal fluid at pH 4.5 and 7.2, (2) physiologic salt solutions (phosphate-buffered saline and saline) commonly used for vaginal lavage sampling in clinical studies of cytokines, and (3) human blood serum. Assays were assessed for reproducibility, linearity, accuracy, and significantly detectable fold difference in cytokine level. Factors with significant impact on cytokine recovery were determined by Kruskal-Wallis analysis of variance with Dunn's multiple comparison test and multiple regression models. All assays showed acceptable intra-assay reproducibility; however, most were associated with significant interlaboratory variation. The smallest reliably detectable cytokine differences ( P < 0.05) derived from pooled interlaboratory data varied from 1.5- to 26-fold depending on assay, cytokine, and matrix type. IL-6 but not IL-1beta determinations were lower in both saline and phosphate-buffered saline as compared to vaginal fluid matrix, with no significant effect of pH. The (electro)chemiluminescence-based assays were most discriminative and consistently detected <2-fold differences within each matrix type. The Luminex-based assays were less discriminative with lower reproducibility between laboratories. These results suggest the need for uniform vaginal sampling techniques and a better understanding of immunoassay platform differences and cross-validation before the biological significance of cytokine variations can be validated in clinical trials. This investigation provides the first standardized analytic approach for assessing differences in mucosal cytokine levels and may improve strategies for monitoring immune responses at the vaginal mucosal interface.
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Affiliation(s)
- Raina N Fichorova
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
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Watson-Jones D, Weiss HA, Rusizoka M, Changalucha J, Baisley K, Mugeye K, Tanton C, Ross D, Everett D, Clayton T, Balira R, Knight L, Hambleton I, Le Goff J, Belec L, Hayes R. Effect of herpes simplex suppression on incidence of HIV among women in Tanzania. N Engl J Med 2008; 358:1560-71. [PMID: 18337596 PMCID: PMC2643126 DOI: 10.1056/nejmoa0800260] [Citation(s) in RCA: 293] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Infection with herpes simplex virus type 2 (HSV-2) is associated with an increased risk of acquiring infection with the human immunodeficiency virus (HIV). This study tested the hypothesis that HSV-2 suppressive therapy reduces the risk of HIV acquisition. METHODS Female workers at recreational facilities in northwestern Tanzania who were 16 to 35 years of age were interviewed and underwent serologic testing for HIV and HSV-2. We enrolled female workers who were HIV-seronegative and HSV-2-seropositive in a randomized, double-blind, placebo-controlled trial of suppressive treatment with acyclovir (400 mg twice daily). Participants attended mobile clinics every 3 months for a follow-up period of 12 to 30 months, depending on enrollment date. The primary outcome was the incidence of infection with HIV. We used a modified intention-to-treat analysis; data for participants who became pregnant were censored. Adherence to treatment was estimated by a tablet count at each visit. RESULTS A total of 821 participants were randomly assigned to receive acyclovir (400 participants) or placebo (421 participants); 679 (83%) completed follow-up. Mean follow-up for the acyclovir and placebo groups was 1.52 and 1.62 years, respectively. The incidence of HIV infection was 4.27 per 100 person-years (27 participants in the acyclovir group and 28 in the placebo group), and there was no overall effect of acyclovir on the incidence of HIV (rate ratio for the acyclovir group, 1.08; 95% confidence interval, 0.64 to 1.83). The estimated median adherence was 90%. Genital HSV was detected in a similar proportion of participants in the two study groups at 6, 12, and 24 months. No serious adverse events were attributable to treatment with acyclovir. CONCLUSIONS These data show no evidence that acyclovir (400 mg twice daily) as HSV suppressive therapy decreases the incidence of infection with HIV. (Current Controlled Trials number, ISRCTN35385041 [controlled-trials.com].).
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LeGoff J, Weiss HA, Gresenguet G, Nzambi K, Frost E, Hayes RJ, Mabey DCW, Malkin JE, Mayaud P, Belec L. Cervicovaginal HIV-1 and herpes simplex virus type 2 shedding during genital ulcer disease episodes. AIDS 2007; 21:1569-78. [PMID: 17630552 DOI: 10.1097/qad.0b013e32825a69bd] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate correlates of herpes simplex virus type 2 (HSV-2) DNA and HIV-1 RNA among women with genital ulcer disease (GUD). DESIGN Baseline data from a randomized placebo-controlled trial of episodic herpes treatment in Ghana and the Central African Republic. METHODS GUD aetiology was determined by polymerase chain reaction (PCR) from a lesional swab. Real-time PCR was used to quantify HIV-1 RNA, and HSV-2 DNA in cervicovaginal lavages (CVL) and HIV-1 RNA in plasma. Genital infection was defined as the presence of virus in the lesion or CVL. RESULTS Of 441 women enrolled, 79.0% were HSV-2 seropositive, 46.6% were HIV-1 seropositive, and 50.0% had an HSV-2 ulcer. Among 180 HSV-2/HIV-1 co-infected women, cervicovaginal HIV-1 RNA was detected more frequently in women with HSV-2 ulcers (67.9%) or cervicovaginal HSV-2 DNA only (72.3%) compared with women without genital HSV-2 infection (42.4%) (P = 0.004). Women with genital HSV-2 infection had higher median cervicovaginal HIV-1-RNA loads (3.14 log10 copies/mL versus 2.10 log10 copies/mL; P = 0.003), higher plasma HIV-1-RNA loads (median 5.10 versus 4.65 log10 copies/mL; P = 0.07), and lower median CD4 cell counts) (198 versus 409 cells/mm, P = 0.03). Cervicovaginal HIV-1 RNA and HSV-2 DNA were significantly correlated after adjusting for plasma HIV-1 RNA and CD4 cell counts (P < 0.001) and a 10-fold increase in cervicovaginal HSV-2 DNA was associated with a 1.7-fold increase in plasma HIV-1 RNA (P = 0.003). CONCLUSION Genital HSV-2 infection is associated with increased cervicovaginal and plasma HIV-1 RNA among co-infected women with genital ulcers, independently of the level of immunodeficiency, highlighting the close interaction between these two viruses and the role of HSV-2 as a co-factor for the sexual transmission of HIV-1.
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Affiliation(s)
- Jérôme LeGoff
- Université Paris Descartes Equipe Immunité et Biothérapie Muqueuse, Unité INSERM Internationale U743 (Immunologie Humaine), Centre de Recherches Biomédicales des Cordeliers, 15 rue de l'Ecole de Médecine, 75270 Paris Cedex 06, France
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Andreoletti L, Skrabal K, Perrin V, Chomont N, Saragosti S, Gresenguet G, Moret H, Jacques J, Longo JDD, Matta M, Mammano F, Belec L. Genetic and phenotypic features of blood and genital viral populations of clinically asymptomatic and antiretroviral-treatment-naive clade a human immunodeficiency virus type 1-infected women. J Clin Microbiol 2007; 45:1838-42. [PMID: 17460054 PMCID: PMC1933108 DOI: 10.1128/jcm.00113-07] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the present study, we assessed whether human immunodeficiency virus type 1 (HIV-1) genetic compartmentalization was associated with phenotypic CCR5 (R5) or CXCR4 (X4) coreceptor usage differences between the systemic and the genital viral populations. Four clinically asymptomatic and treatment-naïve clade A HIV-1-infected patients were selected from a cohort of 274 African women, because they were free of all the biological cofactors known to modify the kinetics of viral production in the genital tract. HIV RNA envelope sequences (V1 to V3) derived from plasma and cervicovaginal secretions (CVS) were amplified, subcloned, and sequenced. CCR5 or CXCR4 coreceptor usage was determined by production of recombinant viral particles, followed by single-cycle infection assays of indicator cell lines, using the tropism recombinant test. In these four selected patients, CVS-derived sequences appeared to be genetically distinct from blood-derived sequences (P < or = 0.001). Two patients were found to harbor virus populations with only the R5 phenotype in both compartments, whereas viruses using CXCR4 in addition to CCR5 were detected in two other patients. In particular, one woman harbored genital virus populations with mixed R5 and X4 phenotypes associated with peripheral blood populations with only the R5 phenotype. These results demonstrate genetic compartmentalization of HIV between the plasma and genital secretions of clinically asymptomatic, treatment-naïve, clade A-infected women. Also, for one patient, we report phenotypic coreceptor usage differences between the systemic (R5) and genital (R5/X4) viral populations. These features may be critical for the development of further mucosal vaccines, therapies, or new preventive strategies to block heterosexual transmission.
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Affiliation(s)
- Laurent Andreoletti
- Laboratoire de Virologie Médicale, Hôpital Robert Debré, Centre Hospitalo-Universitaire de Reims, et Equipe d'Accueil 3798, Faculté de Médecine de Reims, France.
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Saidi H, Eslahpazir J, Eslaphazir J, Carbonneil C, Carthagena L, Requena M, Nassreddine N, Belec L. Differential modulation of human lactoferrin activity against both R5 and X4-HIV-1 adsorption on epithelial cells and dendritic cells by natural antibodies. J Immunol 2007; 177:5540-9. [PMID: 17015741 DOI: 10.4049/jimmunol.177.8.5540] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Human lactoferrin (Lf) is an iron binding glycoprotein that is present in several mucosal secretions. Many biological functions have been ascribed to Lf. In the present study, we showed that Lf limited specifically adsorption of R5- and X4-HIV-1-free particles on endometrial epithelial HEC-1A cells, by inhibiting virus adsorption on heparan-sulfated proteoglycans. But, Lf did not interfere with both R5 and X4-HIV transcytosis. We showed also the efficacy of Lf in preventing R5 and X4-HIV capture by dendritic cells. Conversely, we demonstrated that Lf-reacting natural Abs (NAbs) present within i.v. Ig-enhanced HIV attachment on dendritic cells by forming HIV-Lf-NAbs. HIV particles were able to directly interact with Lf following its interaction with NAbs. We also found Lf-reacting natural Abs within cervicovaginal secretions, suggesting the existence of Lf-NAbs complexes in women genital tract in vivo. In conclusion, this study highlights Lf as a potent microbicides and reports new function for NAbs within the genital compartment that may compartment that may abolish the inhibitory activity of microbicide compounds. Thus, we proposed a model in which Lf would appear as a double-edged sword that could have beneficial or detrimental effects depending on both cellular and molecular environments. This study highlights the use of Lf derivates as microbicide candidates to limit such interferences.
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Affiliation(s)
- Héla Saidi
- Université René Descartes Paris V, Unité Institut National de la Recherche et de la Santé (INSERM) Internationale 743 d'Immunologie Humaine, Centres de Recherches Biomédicales des Cordeliers, Paris, France.
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Legoff J, Tanton C, Lecerf M, Grésenguet G, Nzambi K, Bouhlal H, Weiss H, Belec L. Influence of storage temperature on the stability of HIV-1 RNA and HSV-2 DNA in cervicovaginal secretions collected by vaginal washing. J Virol Methods 2006; 138:196-200. [PMID: 16919788 DOI: 10.1016/j.jviromet.2006.07.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2006] [Revised: 07/07/2006] [Accepted: 07/13/2006] [Indexed: 11/18/2022]
Abstract
Variability in the handling of samples of genital secretions prior to quantitation of HIV-1 RNA and HSV DNA may profoundly affect both the detection and quantitation of these nucleic acids. Over 144 h, we evaluated, the influence of storage temperature (4 degrees C, 20 degrees C, 30 degrees C) on the quantity of HIV-1 RNA and HSV-2 DNA in HIV and HSV negative cervicovaginal lavage pools spiked with known amounts of HIV-1 and HSV-2 and in HIV-1 and HSV-2 co-infected cervicovaginal lavage pools. The level of viral nucleic acids remained stable at 4 degrees C for 24h but decreased significantly when cervicovaginal lavages were stored at 20 degrees C and 30 degrees C, demonstrating that, cervicovaginal lavages to be quantified for viral RNA or DNA require, at minimum, immediate storage at 4 degrees C.
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Affiliation(s)
- Jerome Legoff
- Université Paris V, Equipe Immunité et Biothérapie Muqueuses, Unité INSERM Internationale U743 Immunologie Humaine, & Laboratoire de Virologie, Hôpital Européen Georges Pompidou, rue de l'Ecole de Médecine, Paris, France
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Bouhlal H, Latry V, Requena M, Aubry S, Kaveri SV, Kazatchkine MD, Belec L, Hocini H. Natural antibodies to CCR5 from breast milk block infection of macrophages and dendritic cells with primary R5-tropic HIV-1. J Immunol 2005; 174:7202-9. [PMID: 15905565 DOI: 10.4049/jimmunol.174.11.7202] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In the present study, we demonstrate that breast milk of 66% and 83% of HIV-seronegative and seropositive women, respectively, contains natural Abs of the secretory IgA and IgG isotypes directed against the CCR5 coreceptor for R5-tropic strains of HIV-1. Abs to CCR5 were affinity purified on a matrix to which a synthetic peptide corresponding to the second extracellular loop of CCR5 had been coupled. The purified Abs bound to the CCR5 peptide in a dose-dependent fashion and to both native CCR5 expressed by Chinese hamster ovary cells transfected with CCR5 gene, macrophages, and immature dendritic cells. Although the avidity differed, the amount of anti-CCR5 Abs did not significantly differ between breast milk of HIV-seropositive and -seronegative women. Purified anti-CCR5 Abs inhibited up to 75% infection of macrophages and dendritic cells with HIV(BaL) and HIV(JR-CSF). Our observations provide evidence for a role of natural Abs to CCR5 in breast milk in controlling transmissibility of HIV through breastfeeding.
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Affiliation(s)
- Hicham Bouhlal
- Institut Nationale de la Santé et de la Recherche Médicale (INSERM) U743, Equipe d'Immunité et Biothérapies Muqueuses et Université René Descartes Paris V, Institut Biomédical des Cordeliers, France.
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39
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Mbopi-Keou FX, Mbu RE, Gonsu Kamga H, Kalla GCM, Monny Lobe M, Teo CG, Leke RJ, Ndumbe PM, Belec L. Interactions between human immunodeficiency virus and herpes viruses within the oral mucosa. Clin Microbiol Infect 2005; 11:83-5. [PMID: 15679480 DOI: 10.1111/j.1469-0691.2004.00984.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
There is evidence from clinical case reports and epidemiological studies that human immunodeficiency virus (HIV) can be transmitted through oral sex. Herpes viruses that appear in the oral mucosa might influence the oral replication of HIV. A review of data suggesting that interactions occur between HIV and herpes viruses indicates that such interactions might operate in the oral mucosa. Defining the mechanisms by which herpes viruses interact with HIV in the oral mucosa should permit intervention measures to be targeted more precisely.
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Mbu RE, Mbopi-Keou FX, Alemnji G, Meli C, Eteki N, Nkengasong JN, Belec L, Leke RJ. Unexpectedly high prevalence of sexually transmitted diseases in married women attending family planning clinics in Yaounde, Cameroon. Int J STD AIDS 2005; 16:270-1. [PMID: 15829032 DOI: 10.1258/0956462053420185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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41
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Mbopi-Keou FX, Legoff J, Piketty C, Hocini H, Malkin JE, Inoue N, Scully CM, Porter SR, Teo CG, Belec L. Salivary production of IgA and IgG to human herpes virus 8 latent and lytic antigens by patients in whom Kaposi's sarcoma has regressed. AIDS 2004; 18:338-40. [PMID: 15075558 DOI: 10.1097/00002030-200401230-00030] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
IgG and IgA antibodies with specificities to a latent and a lytic antigen of human herpes virus 8 (HHV-8) were detectable in the saliva and serum of eight patients whose Kaposi's sarcoma had regressed, seven of whom were HIV-1 infected. The measurement of antibody-specific activity and secretion rate, and the detection of secretory IgA all indicate anti-HHV-8 antibody activity in saliva. The specific humoral responses possibly influence mucosal replication of HHV-8, and in turn, that of HIV.
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Affiliation(s)
- Francois-Xavier Mbopi-Keou
- Department of Oral Medicine, Eastman Institute for Oral Health Care Sciences, University College London, London, UK
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42
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Kourtis AP, Butera S, Ibegbu C, Belec L, Duerr A. Breast milk and HIV-1: vector of transmission or vehicle of protection? The Lancet Infectious Diseases 2003; 3:786-93. [PMID: 14652204 DOI: 10.1016/s1473-3099(03)00832-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Transmission of HIV-1 to the infant through breastfeeding is a major cause of new paediatric HIV-1 infections worldwide. Although extended breastfeeding accounts for approximately 40% of infant HIV infections worldwide, most breastfed infants remain uninfected, despite prolonged and repeated exposure to HIV-1. Mechanisms associated with transmission of HIV-1 through breastfeeding and factors related to protection from such transmission remain poorly understood. Here we focus on the cellular origin of HIV in breast milk and on immune factors within the milk that may offer protection from transmission of HIV infection. The presence of innate immunity and induction of adaptive immunity against HIV is explored: in particular, specific antibodies, cellular responses, and their significance. The role of mucosal immune activation and epithelial integrity in HIV transmission is also addressed. We are of the opinion that advances in laboratory methods that study specific aspects of immunity will help open new areas of understanding of HIV transmission through breastfeeding and mechanisms of protection, and contribute to the development of novel prevention strategies.
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Authier FJ, Bassez G, Payan C, Guillevin L, Pawlotsky JM, Degos JD, Gherardi RK, Belec L. Detection of genomic viral RNA in nerve and muscle of patients with HCV neuropathy. Neurology 2003; 60:808-12. [PMID: 12629238 DOI: 10.1212/01.wnl.0000044399.71601.ea] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hepatitis C virus (HCV)-associated neuropathy is usually associated with mixed cryoglobulinemia (MC) and vasculitis. MC may contain viral RNA, and tissues showing vasculitis may contain intracellular HCV. Local HCV replication remains to be evidenced. OBJECTIVE To delineate the spectrum of HCV-associated neuropathy and to assess the presence of HCV in nerve and muscle tissues. METHODS Thirty consecutive HCV-infected patients with peripheral neuropathy were included. Genomic and replicative strands of HCV RNA were detected in both nerve and muscle biopsy samples using distinctive reverse transcription nested PCR. RESULTS Neuropathy was consistent with distal axonal polyneuropathy (DPN) in 25 of 30 patients, mononeuropathy multiplex (MM) in 3 of 30, and demyelinating polyneuropathy in 2 of 30. Pain was present in 18 of 30 patients and MC in 16 of 30. Biopsy showed inflammatory vascular lesions in 26 of 30 patients (87%), including necrotizing arteritis (6/30), small-vessel vasculitis (12/30) of either the lymphocytic (9/12) or the leukocytoclastic (3/12) type, and perivascular inflammatory infiltrates (8/30). All patients with necrotizing arteritis had DPN and positive MC detection. Both pain (p < 0.03) and positive MC detection (p < 0.01) were associated with the presence of vasculitis. Positive-strand genomic HCV RNA was detected in tissues of 10 of 30 patients (muscle 9, nerve 3). In contrast, negative-strand replicative RNA was never detected. Genomic RNA was found in nerve tissue samples showing vasculitis (necrotizing arteritis 2, small-vessel lymphocytic vasculitis 1). CONCLUSION Painful DPN associated with MC and neuromuscular vasculitis is the most frequent type of HCV neuropathy. The usual detection of MC and the lack of local HCV replication indicate that HCV neuropathy results from virus-triggered immune-mediated mechanisms rather than direct nerve infection and in situ replication.
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Affiliation(s)
- F-J Authier
- Groupe nerf-muscle, Département de pathologie, Hôpital Henri Mondor, Créteil, France.
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Mbopi-Keou FX, Robinson NJ, Mayaud P, Belec L, Brown DWG. Herpes simplex virus type 2 and heterosexual spread of human immunodeficiency virus infection in developing countries: hypotheses and research priorities. Clin Microbiol Infect 2003; 9:161-71. [PMID: 12667248 DOI: 10.1046/j.1469-0691.2003.00550.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Herpes simplex virus type 2 (HSV-2) infection is almost always sexually transmitted, and causes genital ulceration. Significant progress in our understanding of HSV infection has occurred over the last decade, in part related to the development of accurate and sensitive laboratory tests to study HSV-2. The application of PCR and type-specific serology to individual cases and in population-based studies has enabled the identification of a potentially important role for HSV-2 infection as a cofactor in the sexual transmission of HIV. This is a particular issue in developing countries. This review describes the epidemiology of HSV-2 infection in the HIV era, the hypotheses regarding HSV-HIV interactions, and research priorities for the developing world.
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Affiliation(s)
- F X Mbopi-Keou
- Department of Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, UCL, University of London, UK.
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Carreno MP, Krieff C, Irinopoulou T, Kazatchkine MD, Belec L. Enhanced transcytosis of R5-tropic human immunodeficiency virus across tight monolayer of polarized human endometrial cells under pro-inflammatory conditions. Cytokine 2002; 20:289-94. [PMID: 12633571 DOI: 10.1006/cyto.2002.2009] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Most cases of human immunodeficiency virus (HIV) infection worldwide occur following sexual contact, implying that the virus may breach the protective epithelial barrier lining the genital tract. HIV infection is known to preferentially occur when the genital epithelial integrity is altered, particularly when epithelial micro-ulcerations occur during heterosexual intercourse or ulcerations appear, due to sexually transmitted infections or else in the context of ectopy of the endocervical mucosa, which may leave the genital tissue. We report that R5-tropic infectious HIV-1 isolates are capable of in vitro transcytosis through a tight and polarized monolayer of human endometrial HEC-1 cells. Transcytosis of HIV particles was increased 2-fold within a pro-inflammatory micro-environment. Our findings suggest that transcytosis may be a relevant mechanism for the passage of virus through the genital mucosa in vivo, particularly when inflammatory cells and mediators are present in the vicinity of the mucosal surface.
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Affiliation(s)
- Marie-Paule Carreno
- Institut National de la Santé et de la Recherche Médicale, Unité 430, Hôpital Broussais, Paris, France.
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Bouhlal H, Chomont N, Haeffner-Cavaillon N, Kazatchkine MD, Belec L, Hocini H. Opsonization of HIV-1 by semen complement enhances infection of human epithelial cells. J Immunol 2002; 169:3301-6. [PMID: 12218150 DOI: 10.4049/jimmunol.169.6.3301] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In the present study we demonstrate that both X4- and R5-tropic HIV-1 strains are able to infect the human epithelial cell line HT-29. Infection was enhanced 2-fold when HIV was added to semen before contact with the cell cultures. The enhancing effect of semen was complement dependent, as evidenced by blockage of generation of C3a/C3a(desArg) in semen by heat or EDTA treatment of semen and suppression of semen-dependent enhancement with mAbs directed to complement receptor type 3 (CD11b/CD18) and soluble CD16. Infection of HT-29 cells was assessed by the release of p24 Ag in cultures and semiquantitative PCR of the HIV-1 pol gene. Inhibition of infection of HT-29 by stromal cell-derived factor 1 was decreased in the case of semen-opsonized X4- and R5-tropic virus compared with unopsonized virus. In contrast, inhibition of infection by RANTES was increased for opsonized X4-tropic HIV-1 compared with unopsonized virus. Taken together these observations indicate that activation of complement in semen may play an enhancing role in mucosal transmission of HIV-1 by facilitating infection of epithelial cells and/or enhancing infection of complement receptor-expressing target cells in the mucosa.
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Affiliation(s)
- Hicham Bouhlal
- Institut National de la Santé et de la Recherche Médicale, Unité 430, and Université Pierre et Marie Curie, Paris, France
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Carreno MP, Chomont N, Kazatchkine MD, Irinopoulou T, Krief C, Mohamed AS, Andreoletti L, Matta M, Belec L. Binding of LFA-1 (CD11a) to intercellular adhesion molecule 3 (ICAM-3; CD50) and ICAM-2 (CD102) triggers transmigration of human immunodeficiency virus type 1-infected monocytes through mucosal epithelial cells. J Virol 2002; 76:32-40. [PMID: 11739669 PMCID: PMC135694 DOI: 10.1128/jvi.76.1.32-40.2002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Transmigration of human immunodeficiency virus (HIV)-infected mononuclear cells through the genital mucosa is one of the possible mechanisms of sexual transmission of HIV. Here, we investigated the transmigration of cell-associated R5-tropic HIV type 1 (HIV-1) through a tight monolayer of human epithelial cells in vitro. We show that this process is dependent on an initial interaction between alphaLbeta2 integrin CD11a/CD18 on infected monocytic cells and intercellular adhesion molecule 2 (ICAM-2; CD102) and ICAM-3 (CD50) on the apical membrane of epithelial cells. The CD50 and CD102 ligands were overexpressed on epithelial cells when the cells were activated by proinflammatory cytokines in the cellular microenvironment. An accumulation of proviral DNA was found in the transmigrated cells, clearly reflecting the preferential transepithelial migration of HIV-1-infected cells under proinflammatory conditions. Our observations provide new insights supporting the hypothesis that HIV-infected mononuclear cells contained in genital secretions from infected individuals may cross the epithelial genital mucosa of an exposed receptive sexual partner, particularly under inflammatory conditions of damaged genital tissue. Understanding the fundamental aspects of the initial HIV entry process during sexual transmission remains a critical step for preventing human infection and developing further vaccinal strategies and virucidal agents.
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Affiliation(s)
- Marie-Paule Carreno
- Unité 430, Hôpital Broussais, Institut National de la Santé et de la Recherche Médicale. Université Pierre et Marie Curie (Paris VI), Paris, France.
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Landau A, Batisse D, Piketty C, Duong Van Huyen JP, Bloch F, Belec L, Bruneval P, Weiss L, Jian R, Kazatchkine MD. Long-term efficacy of combination therapy with interferon-alpha 2b and ribavirin for severe chronic hepatitis C in HIV-infected patients. AIDS 2001; 15:2149-55. [PMID: 11684934 DOI: 10.1097/00002030-200111090-00010] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND We have assessed the long-term efficacy and safety of a combination therapy of interferon alpha-2b (IFN) and ribavirin (RBV) for the treatment of severe chronic hepatitis C in co-infected HIV-seropositive patients in an open prospective study. METHODS Fifty-one patients were treated for 12 months. Mean baseline CD4 cell count, alanine aminotransferase and aspartate aminotransferase were 412 +/- 232 x 106/l, 113 +/- 75 IU/l and 111 +/- 84 IU/l respectively. The mean Knodell score was 11.5 +/- 2.1 with 28 patients (55%) exhibiting histological evidence of active cirrhosis. RESULTS Fifteen (29%) patients discontinued the treatment prematurely because of adverse events. An end of treatment response (ETR) as defined by the lack of detectable hepatitis C virus (HCV) RNA in plasma at the end of treatment was achieved in 15 patients (29%). A sustained virological response (SVR), defined by the lack of detectable HCV RNA in plasma 6 months after completion of combination therapy, was achieved in 11 patients (21%). The HCV genotype 3a was associated with ETR and SVR (P = 0.002 and P = 0.003, respectively). HCV viraemia at baseline was lower in patients who achieved SVR and ETR than in those who did not (6.7 +/- 7.8 versus 24 +/- 26.7 x 10(6) genome equivalents/ml, P = 0.03 and 14.3 +/- 28.7 versus 22.5 +/- 23, P = 0.05, respectively). CONCLUSION Our results indicate that combination therapy with IFN and RBV is effective in approximately 20% of co-infected patients with severe liver disease.
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Affiliation(s)
- A Landau
- Department of Hepatology and Gastroenterology, Hôpital Européen Georges Pompidou and Université Pierre et Marie Curie, Paris, France
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Gherardi RK, Coquet M, Cherin P, Belec L, Moretto P, Dreyfus PA, Pellissier JF, Chariot P, Authier FJ. Macrophagic myofasciitis lesions assess long-term persistence of vaccine-derived aluminium hydroxide in muscle. Brain 2001; 124:1821-31. [PMID: 11522584 DOI: 10.1093/brain/124.9.1821] [Citation(s) in RCA: 231] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Macrophagic myofasciitis (MMF) is an emerging condition of unknown cause, detected in patients with diffuse arthromyalgias and fatigue, and characterized by muscle infiltration by granular periodic acid-Schiff's reagent-positive macrophages and lymphocytes. Intracytoplasmic inclusions have been observed in macrophages of some patients. To assess their significance, electron microscopy was performed in 40 consecutive cases and chemical analysis was done by microanalysis and atomic absorption spectrometry. Inclusions were constantly detected and corresponded to aluminium hydroxide, an immunostimulatory compound frequently used as a vaccine adjuvant. A lymphocytic component was constantly observed in MMF lesions. Serological tests were compatible with exposure to aluminium hydroxide-containing vaccines. History analysis revealed that 50 out of 50 patients had received vaccines against hepatitis B virus (86%), hepatitis A virus (19%) or tetanus toxoid (58%), 3-96 months (median 36 months) before biopsy. Diffuse myalgias were more frequent in patients with than without an MMF lesion at deltoid muscle biopsy (P < 0.0001). Myalgia onset was subsequent to the vaccination (median 11 months) in 94% of patients. MMF lesion was experimentally reproduced in rats. We conclude that the MMF lesion is secondary to intramuscular injection of aluminium hydroxide-containing vaccines, shows both long-term persistence of aluminium hydroxide and an ongoing local immune reaction, and is detected in patients with systemic symptoms which appeared subsequently to vaccination.
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Affiliation(s)
- R K Gherardi
- Equipe mixte INSERM E 0011/Université Paris XII, France.
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50
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Si-Mohamed A, Andreoletti L, Colombet I, Carreno MP, Lopez G, Chatelier G, Kazatchkine MD, Belec L. Quantitation of human immunodeficiency virus type 1 (HIV-1) RNA in cell-free cervicovaginal secretions: comparison of reverse transcription-PCR amplification (AMPLICOR HIV-A MONITOR 1.5) with enhanced-sensitivity branched-DNA assay (Quantiplex 3.0). J Clin Microbiol 2001; 39:2055-9. [PMID: 11376034 PMCID: PMC88088 DOI: 10.1128/jcm.39.6.2055-2059.2001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Two commercially available hypersensitive assays for human immunodeficiency virus type 1 (HIV-1) RNA quantitation, AMPLICOR HIV-1 Monitor Test 1.5 and Quantiplex HIV RNA 3.0, were compared to detect and quantify HIV-1 RNA in the cell-free fraction of cervicovaginal secretions collected by vaginal washing. Three panel specimens were used: pooled cervicovaginal secretions spiked with HIV-1 subtype A or HIV-1 subtype B and cervicovaginal lavages from HIV-positive and HIV-negative women. Compared to the AMPLICOR HIV-1 Monitor Test 1.5 assay, the Quantiplex HIV-1 3.0 assay yielded higher estimates of HIV-1 RNA concentrations in several tested samples spiked with HIV-1 RNA subtype A, as well as subtype B, particularly samples containing low amounts of HIV-1 RNA. The sensitivity and specificity of the AMPLICOR HIV-1 Monitor Test 1.5 assay were 93 and 100%, respectively; the sensitivity and specificity of the Quantiplex HIV RNA 3.0 assay were 97 and 50%, respectively. In conclusion, in quantifying HIV-1 RNA in cervicovaginal secretions, the Quantiplex HIV RNA 3.0 may lack specificity, and the AMPLICOR HIV-1 Monitor Test 1.5 assay, although highly specific, may lack sensitivity.
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Affiliation(s)
- A Si-Mohamed
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75 908 Paris Cedex 15, France.
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