Seronegativation in Early Treated HIV-Infected Infants: Frequency and Potential Implications on Care and Follow-up in a Resource-Limited Country

Kfutwah, Anfumbom; Tejiokem, Mathurin Cyrille; Ateba, Francis Ndongo; Ndongo, Jean Audrey; Penda, Calixte Ida; Ngoupo, Paul Alain; Tchendjou, Patrice; Chewa, Gisele; Boisier, P.; Rouzioux, Christine; Warszawski, Josiane; Faye, Albert

doi:10.1097/qai.0b013e31822d49f0

Cited by 5 publications

(5 citation statements)

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“…Indeed, the more rapidly viral suppression is achieved, lower is the reservoir [5,[7][8][9][10][11]12,13]. In general, total HIV-DNA inversely correlates with the time spent with undetectable viremia [13], and very early initiation of antiretroviral therapy (in the first days or months of life) has been associated with undetectable HIV-DNA levels in blood CD4+T cells or negative serological tests in some children [8,10,[13][14][15][16][17]. Nonetheless, few data on the long-term benefit of early cART initiation for children after the age of 2 and in adolescents are available.…”

Section: Introductionmentioning

confidence: 99%

Initiating Antiretroviral Treatment Early in Infancy Has Long-term Benefits on the Human Immunodeficiency Virus Reservoir in Late Childhood and Adolescence

Avettand-Fènoël

Lechenadec

Diallo

et al. 2021

Clinical Infectious Diseases

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Background Early combined antiretroviral therapy (cART) limits the total HIV-DNA load in children. However, data on its impact in older children and adolescents remain scarce. This study aims to compare HIV reservoirs in children (5-12 years) and adolescents (13-17 years) who started cART before 6 months (early (E-)group) or after 2 years old (late (L-)group). Methods The ANRS-EP59-CLEAC study prospectively enrolled 76 HIV-1 perinatally-infected patients who reached HIV-RNA<400 copies/mL less than 24 months after cART initiation, regardless of subsequent viral suppression (E-group: 27 children, 9 adolescents; L-group: 19 children, 21 adolescents). Total and integrated HIV-DNA were quantified in blood and in CD4+ T cell subsets. A substudy assessed HIV reservoir inducibility after ex vivo peripheral blood mononuclear cells (PBMCs) stimulation. Results Total HIV-DNA levels were lower in early- than late-treated patients (Children: 2.14 vs 2.87 log cp/million PBMCs, p<0.0001; Adolescents: 2.25 vs 2.74log, p<0.0001). Low reservoir was independently associated with treatment precocity, protective HLA and low cumulative viremia since cART initiation. The 60 participants with undetectable integrated HIV-DNA started cART earlier than the other patients (4 vs 54 months, p=0.03). In those with sustained virological control, transitional memory and effector memory CD4+T cells were less infected in the E-group than in the L-group (p=0.03 and 0.02, respectively). Viral inducibility of reservoir cells after normalization to HIV-DNA levels was similar between the groups. Conclusions Early cART results in a smaller blood HIV reservoir until adolescence, but all tested participants had an inducible reservoir. This deserves cautious consideration for HIV remission strategies.

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Section: Introductionmentioning

confidence: 99%

Initiating Antiretroviral Treatment Early in Infancy Has Long-term Benefits on the Human Immunodeficiency Virus Reservoir in Late Childhood and Adolescence

Avettand-Fènoël

Lechenadec

Diallo

et al. 2021

Clinical Infectious Diseases

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“…Out of the 29 studies included in this review, only two reported data on the profile of cellular reservoirs among 136 enrolled children. A pro-viral DNA load mean of 3.34±1.05 log 10 /mL without genotypic characterization was observed among five HIV infected children over 57 enrolled during the ANRS-Pediacam study in 2007 [ 50 ]. As for the genotyping aspect in the Cameroonian context, archived HIV drug resistance mutations were identified exclusively in pro-viral DNA marker among 21 of 79 adolescents vertically HIV-infected failing antiretroviral therapy and enrolled in the Centre health facilities in 2019 [ 51 ].…”

Section: Resultsmentioning

confidence: 99%

The mother-to-child transmission of HIV-1 and profile of viral reservoirs in pediatric population: A systematic review with meta-analysis of the Cameroonian studies

et al. 2023

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Background The mother-to-child transmission of HIV-1 (MTCT) remains on the major route of HIV-transmission among pediatric populations in Africa. Though a prevention of MTCT (PMTCT) high-priority country, data on the MTCT burdens in Cameroon remains fragmented. Objective We sought to assess the pooled MTCT rate, its risk-factors, and to characterize viral reservoirs of infected-children in Cameroon. Methods All relevant observational cohort and cross-sectional studies conducted in Cameroon were searched from PubMed, African Journals Online, Google scholar, ScienceDirect and academic medical education databases. Heterogeneity and publication bias were respectively assessed by the I2 statistic and the Egger/funnel plot test. Meta-analysis was performed using the random effects model. MTCT rate >5% was considered as “high”. This review was registered in the Prospero database, CRD42021224497. Results We included a total of 29 studies and analyzed 46 684 children born from HIV-positive mothers. The overall rate of MTCT was 7.00% (95% CI = 6.07–8.51). According to regions, the highest burden was in Adamaoua-region (17.51% [95% CI:14.21–21.07]) with only one study found. PMTCT option-B+ resulted in about 25% reduction of MTCT (8.97% [95% CI: 8.71–9.24] without option-B+ versus 2.88% [95% CI: 5.03–9.34] with option-B+). Regarding risk-factors, MTCT was significantly associated with the absence of PMTCT-interventions both in children (OR:5.40 [95% CI: 2.58–11.27]) and mothers (OR: 3.59 [95% CI: 2.15–5.99]). Regarding viral reservoirs, a pro-viral DNA mean of 3.34±1.05 log10/mL was observed among 5/57 children and archived HIV drug resistance mutations were identified in pro-viral DNA marker among 21/79 infected-children. Conclusion In spite of the dropdown in MTCT following option-B+ implementation, MTCT remains high in Cameroon, with substantial disparities across regions. Thus, in this era of option-B+, achieving MTCT elimination requires interventions in northern-Cameroon. The variation in pro-viral load in infected-children underlines the relevance of characterizing viral reservoirs for possible infection control in tropical settings.

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“…At the time of the RHT, her ELISA test was rendered as “reactive”(i.e., positive) in our laboratory but with a low ratio (i.e., 3.6, whereas the threshold is ≥1 S/CO—Abbott Architect HIV Ag/Ab Combo). Such a low density of specific antibodies can easily explain the negative reading of the rapid test [Kfutwah et al, ].…”

Section: Discussionmentioning

confidence: 99%

Reliability of the INSTI® rapid test for the diagnosis of HIV‐1 non‐B subtypes and recombinant variants

Bouillé

Moal

Hocqueloux

et al. 2015

Journal of Medical Virology

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Data regarding the efficacy of Rapid HIV tests (RHTs) in detecting non-B subtype HIV-1 are limited. We evaluated the sensitivity of the INSTI® test for the detection of HIV-1 antibodies for the diagnosis of HIV-1 non-B subtypes and recombinant variants. We identified adults with HIV-1 infection due to non-B subtypes and recombinant variants. The participants were re-tested with INSTI® test. We included 258 patients. Overall, the INSTI® test sensitivity was 98.4% (95%CI: 96.9-99.9%). For the major CRF_02AG subtype, the sensitivity was 99.0% (95%CI: 97.1-100%). The HIV INSTI® test is reliable for the detection of various non-B HIV-1 antibodies.

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Seronegativation in Early Treated HIV-Infected Infants: Frequency and Potential Implications on Care and Follow-up in a Resource-Limited Country

Cited by 5 publications

References 9 publications

Initiating Antiretroviral Treatment Early in Infancy Has Long-term Benefits on the Human Immunodeficiency Virus Reservoir in Late Childhood and Adolescence

Initiating Antiretroviral Treatment Early in Infancy Has Long-term Benefits on the Human Immunodeficiency Virus Reservoir in Late Childhood and Adolescence

The mother-to-child transmission of HIV-1 and profile of viral reservoirs in pediatric population: A systematic review with meta-analysis of the Cameroonian studies

Reliability of the INSTI® rapid test for the diagnosis of HIV‐1 non‐B subtypes and recombinant variants

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