Abou Abdallah Malick Diouara

The case for addressing primary resistance mutations to non-nucleoside reverse transcriptase inhibitors to treat children born from mothers living with HIV in sub-Saharan Africa

The prevalence of human immunodeficiency virus (HIV) drug resistance mutations (DRMs) was estimated in 25 untreated infants who were living with HIV‐1, younger than 13 months and living in Senegal. Antiretroviral DRMs were detected in 8 of 25 (32%) children. Non‐nucleoside reverse transcriptase inhibitor (NNRTI) DRMs were present in all (100%) children whose viruses harboured DRMs: K103N in 43%; Y181C, K101E and V106M each in 29%; and Y188L in 14%. The D67N thymidine‐analogue mutation was observed in only two children whose mothers had received chemoprophylaxis of mother‐to‐child transmission (MTCT). The proportion of children whose viruses harboured DRMs was then 6.5‐fold higher in children whose mother–child couples had received nevirapine (NVP)‐based chemoprophylaxis than in other couples without prophylaxis [7 of 13 (53.8%) vs. 1 of 12 (8.3%)]. These findings point to the absolute need to address primary resistance mutations in case of virological failure in young children treated by antiretroviral drugs, and to make more effective treatment regimens available to NVP‐exposed infants living with HIV‐1 in Senegal.

Performance of the ViroSeq HIV-1 genotyping system v2.0 on HIV-1 strains circulating in Senegal

The objective of this study was to investigate the performance of the ViroSeq HIV-1 Genotyping System v2.0 on HIV-1 non-B strains identified in Senegalese patients. The study involved 150 patients, and genotyping was performed using the ViroSeq HIV-1 Genotyping System v2.0 or an in-house method developed by the French National Agency on AIDS Research AC11 when the ViroSeq HIV-1 Genotyping System v2.0 failed. The sequences were edited to assess the performance of sequencing primers at their presumed binding regions. The Polymorphism was studied in the regions between the sequences of Senegalese patients and the subtype B strains used as references. The phylogenetic analysis showed a predominance of CRF02_AG (88/150; 58.7%) and the circulation of 11 subtypes/CRFs, 16 unique recombinant forms (URFs) and one unclassified sample. The amplification and sequencing rates were 98% (147/150) and 96.6% (142/147), respectively. This study showed that only primer B exhibited 100% success, while the failure rate ranged from 1.4% to 71.4% for the other primers (D: 71.4%, A and H: 12.2%, F: 7.5%, G: 5.5% and C: 1.4%). These findings suggest the need for an alternative method or alternative primers for non-B strains that were not sequenced successfully using the ViroSeq HIV-1 Genotyping System v2.0.

Antiretroviral treatment outcome in HIV-1-infected patients routinely followed up in capital cities and remote areas of Senegal, Mali and Guinea-Conakry

Access to antiretroviral treatment (ART) becomes more and more effective in resource‐limited settings (RLS). However, this global effort would be even more profitable if the access to laboratory services especially in decentralized settings was strengthened. We report the virological outcome and HIV‐1 drug resistance in three West African countries using dried blood spots (DBS) samples.

Response to comments by Hønge et al. on our paper titled “Prevalence of hepatitis B markers in Senegalese HIV‐1 infected patients”

Gora Lô, Amina Sow-Sall, Halimatou Diop-Ndiaye, Nokoa Chadia Ines Danty Mandiouba, Moussa Thiam, Fatou Diop, Ousseynou Ndiaye, Sokhna Bousso Gueye, Sidy Mouhamed Seck, Abou Abdallah Malick Diouara, Moustapha Mbow, A€ıssatou Gaye-Diallo, Souleymane Mboup, and Coumba Tour e-Kâne* Bacteriology and Virology Laboratory at Le Dantec Teaching Hospital of Dakar, Dakar, Senegal University of Gaston Berger of Saint Louis, Saint Louis, Senegal

Utilisation des prélèvements capillaires sur buvard dans le diagnostic précoce de l’infection à VIH-1 chez des enfants nés de mères infectées dans le cadre de la prévention de la transmission mère–enfant au Bénin@@@Use of dried blood spots in early diagnosis of HIV-1 infection in children born to HIV-infected mothers as part of the prevention of mother-to-child transmission in Benin

The goal of this study was to evaluate using the molecular diagnosis, infection transmission rate of HIV in children born to HIV-1 positive mothers as part of the prevention of mother-to-child transmission (PMTCT) in Benin. The sample consisted of 524 dried blood spots (DBS) of children born to HIV-1 positive mothers, from 30 sites (PMTCT) taken between October 2009 and June 2010. The diagnosis of HIV-1 was performed by the qualitative detection of viral nucleic acids (RNA and DNA) in DBS on filter paper using the Abbott RealTime(®) HIV-1 Qualitative assay. We found that 51 DBS were positive (9.7%) and 473 were negative (90.3%). The failure rate of PMTCT among 420 mothers who received antiretroviral prophylaxis was 6.7% (28/420). This failure rate was significantly higher among children born to infected mothers on antiretroviral monotherapy than on triple therapy (HAART). The results of our study enrich the data in the literature on highly active antiretroviral chemoprophylaxis to reduce the transmission of HIV-1 from mother to child.

Utilisation des prélèvements capillaires sur buvard dans le diagnostic précoce de l’infection à VIH-1 chez des enfants nés de mères infectées dans le cadre de la prévention de la transmission mère–enfant au Bénin

The goal of this study was to evaluate using the molecular diagnosis, infection transmission rate of HIV in children born to HIV-1 positive mothers as part of the prevention of mother-to-child transmission (PMTCT) in Benin. The sample consisted of 524 dried blood spots (DBS) of children born to HIV-1 positive mothers, from 30 sites (PMTCT) taken between October 2009 and June 2010. The diagnosis of HIV-1 was performed by the qualitative detection of viral nucleic acids (RNA and DNA) in DBS on filter paper using the Abbott RealTime(®) HIV-1 Qualitative assay. We found that 51 DBS were positive (9.7%) and 473 were negative (90.3%). The failure rate of PMTCT among 420 mothers who received antiretroviral prophylaxis was 6.7% (28/420). This failure rate was significantly higher among children born to infected mothers on antiretroviral monotherapy than on triple therapy (HAART). The results of our study enrich the data in the literature on highly active antiretroviral chemoprophylaxis to reduce the transmission of HIV-1 from mother to child.

Quantification of Viral load and resistance tests of HIV-1 to ARVs from dried blood spots samples in Guinean patients undergoing antiretroviral treatment

Problematique: Comme dans plusieurs pays du Sud, le suivi virologique des patients sous traitement antiretroviral (TARV) en Guinee est timide voire inexistant dans certaines localites. Le but de cette etude etait d’evaluer la faisabilite technique et logistique de l’utilisation des DBS dans les tests de charge virale (CV) et de genotypage. Methode: De septembre a octobre 2010, les DBS ont ete prepares a partir de prelevements sanguins de patients adultes sous TARV. Le delai d’envoi des echantillons au laboratoire de reference etait de 30 jours maximum apres le prelevement et se faisait a temperature ambiante. La CV a ete quantifiee et les echantillons de patients en echec virologique (CV ≥ 3 log10 copies/mL) ont ete genotypes selon le protocole de l’ANRS. L’algorithme de Stanford version 6.0.8 a ete utilise pour l’analyse et l’interpretation des mutations de resistance. Resultats: Parmi les 136 patients inclus, 129 et 7 etaient respectivement sous premiere et deuxieme ligne de traitement avec une mediane de suivi de 35 mois [IQR: 6-108]. L’echec virologique a ete note chez 33 patients. Parmi eux, 84.8% ( n = 28/33) ont beneficie d’ungenotypage. Le taux de resistance global etait de 14% ( n = 19/136). Le CRF02_AG etait le sous type viral le plus prevalent (82%; n = 23). Conclusion: En plus de montrer la faisabilite technique et logistique des tests de CV et de genotypage a partir des DBS, ces resultats montrent l’interet de leurs utilisations dans le suivi virologique des patients sous TARV. Cette etude a permis egalement de documenter l’echec virologique, la resistance aux ARV et la diversite genetique du VIH-1 en Guinee. Mots cles: VIH-1, Resistance aux ARV, DBS (Dried Blood Spots), Guinee Conakry, Genotypage,Charge Virale. Quantification of Viral load and resistance tests of HIV-1 to ARVs from dried blood spotssamples in Guinean patients undergoing antiretroviral treatment. Problem: As in several countries of the South, the virological monitoring of patients undergoing antiretroviral treatment (ARVT) in Guinea is low or non-existent in some locations. The aim ofthis study was to assess the technical and logistical feasibility of the use of (dried blood spots) DBSs in viral load (VL) and genotyping tests. Method: From September 2010 to October 2010, DBS were prepared from blood samples of adult patients under ARVT. The samples had to be sent to the reference laboratory within 30 days after the sample had been done at ambient temperature. The VL was quantified and the samples of patients with virological failure (CV ≥ 3 log10 copies/mL) were genotyped according to the ANRS protocol. The Stanford algorithm, version 6.0.8, was used to analyse and interpret the resistance mutations. Results: Amongst the 136 included patients, 129 and 7 were under first and second line treatment respectively, and monitored for an average of 35 months [IQR: 6-108]. Virological failure was noticed among 33 patients. Among them, 84.8% ( n = 28/33) benefited from genotyping. The global resistance rate was 14% ( n = 19/136). CRF02_AG was the most prevalent viral subtype (82%; n = 23). Conclusion: In addition to demonstrating the technical and logistic feasibility of VL and genotyping tests from DBSs, these results show the relevance of their use in the virological monitoring of patients under ARVT. Also, this study made it possible to provide informationon virological failure, ARV resistance and the HIV-1 genetic diversity in Guinea.