BackgroundSeveral studies have reported that the metabolic syndrome (MS) is more common in subjects with HIV infection than in HIV-negative individuals. HIV infection and the use of Highly Active Antiretroviral Therapy (HAART) have been shown to predispose HIV-infected persons to MS. In this study, we report the prevalence of MS in Cameroonian HIV-infected subjects receiving different combinations of HAART as well as HIV patients who have never received antiretroviral drugs.MethodsIn this cross-sectional study, 173 treated and untreated HIV-infected out-patients (aged 18–70 years) managed at the Buea and Limbe Regional Hospitals and 50 seronegative individuals (controls) were recruited after obtaining their consent. Ethical approval for this study was obtained from the National Ethics Committee of Cameroon. Metabolic syndrome prevalence was examined using the U.S. National Cholesterol Education Program Adult Treatment Panel III (ATPIII) criteria. Data was analyzed using SPSS® (Statistical Package for the Social Sciences, SPSS Inc., Chicago, IL, USA) version 16. Statistical significance was set at p < 0.05.Results and discussionThe prevalence of MS among the HIV patients was 15.6% (27/173) and 8% (4/50) among the controls and the difference was significant (p = 0.022). MS was more prevalent in HIV-infected patients on HAART than in ART-naive patients and seronegative individuals. Overall, the prevalence of MS was significantly higher (p = 0.003) in females (28/153; 18.3%) than in males (3/70; 4.3%). The patients on first-line drugs demonstrated the highest MS prevalence (15/62; 24.2%) followed by the ART-naïve group of patients (7/61; 11.5%) and the lowest prevalence was among the patients on protease inhibitors (5/50; 10%). Patients on the drug combination Lamivudine/Stavudine/Nevirapine had the highest prevalence of MS (50%).ConclusionsIn this study, HAART but not HIV disease plays a significant role in the development of MS. The metabolic complications as a result of treatment with HAART may predispose HIV patients to developing cardiovascular diseases and diabetes, in spite of improvements in morbidity and mortality conferred by immune reconstitution as a result of HAART treatment.

Background The presence of high-abundance drug-resistant HIV-1 jeopardizes success of antiretroviral therapy (ART). Despite numerous investigations, the clinical impact of low-abundance drug-resistant HIV-1 variants (LA-DRVs) at levels &lt;15%–25% of the virus population in antiretroviral (ARV) drug-naive individuals remains controversial. Methods We systematically reviewed 103 studies assessing prevalence, detection methods, technical and clinical detection cutoffs, and clinical significance of LA-DRVs in antiretroviral drug-naive adults. Results In total, 14 919 ARV drug-naive individuals were included. Prevalence of LA-DRVs (ie, proportion of individuals harboring LA-DRVs) was 0%–100%. Technical detection cutoffs showed a 4 log range (0.001%–10%); 42/103 (40.8%) studies investigating the impact of LA-DRVs on ART; 25 studies included only individuals on first-line nonnucleoside reverse transcriptase inhibitor-based ART regimens. Eleven of those 25 studies (44.0%) reported a significantly association between preexisting LA-DRVs and risk of virological failure whereas 14/25 (56.0%) did not. Conclusions Comparability of the 103 studies is hampered by high heterogeneity of the studies’ designs and use of different methods to detect LA-DRVs. Thus, evaluating clinical impact of LA-DRVs on first-line ART remains challenging. We, the WHO HIVResNet working group, defined central areas of future investigations to guide further efforts to implement ultrasensitive resistance testing in routine settings.

Cycloviruses, small ssDNA viruses of the Circoviridae family, have been identified in the cerebrospinal fluid from symptomatic human patients. One of these species, cyclovirus-Vietnam (CyCV-VN), was shown to be restricted to central and southern Vietnam. Here we report the detection of CyCV-VN species in stool samples from pigs and humans from Africa, far beyond their supposed limited geographic distribution.

Blood transfusion remains a routine life‐saving medical procedure that helps replace blood lost due to surgery, injury or disease. The quality of transfused blood is crucial in this process as blood donors must be free of transfusion‐transmissible infections and donated blood should be compatible to that of the recipient. The quality of donated blood could be affected by the quality of in vitro diagnostic medical devices (IVDs) used in the screening process. Consequently, the need for high‐quality, safe and well‐performing IVDs for use in transfusion medicine arises, accompanied by the need for tight regulations in this domain. In the European Union, the new IVD Regulation will replace the existing IVD Directive within a five‐year transitional period. Manufacturers of IVDs are expected to fully comply with the new Regulation by 26 May 2022. In this review, we address the major differences relating to marketing authorization and testing between this new Regulation and its predecessor. We further present the main elements of the prequalification assessment introduced by the WHO for IVDs, including disease‐specific IVDs for blood screening laboratories.