Publications by authors named "Ka E"

Dual therapies (DT) combining integrase strand transfer inhibitors (INSTIs) with second-generation non-nucleoside reverse transcriptase inhibitors (2nd-Gen-NNRTIs) offer new possibilities for HIV treatment to improve adherence. However, drug resistance associated mutations (RAMs) to prior antiretrovirals may jeopardize the efficacy of DT. We herein describe the predicted efficacy of DT combining INSTIs + 2nd-Gen-NNRTI following treatment failure among Cameroonian patients.

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Introduction: In low-and-middle-income-countries (LMIC), viral suppression is defined as plasma viral load (PVL) below 1000 copies/mL (low-level viremia [LLV]) and threshold for HIV drug resistance (HIVDR) testing. However, there is evidence that drug resistance mutations (DRMs) may emerge at LLV, thus compromising antiretroviral treatment (ART) response We evaluated sequencing success rates (SSR) at LLV, described HIVDR profiles and adequacy with potential efficacy of tenofovir-lamivudine-dolutegravir (TLD).

Methods: A cross-sectional study was conducted among individuals with LLV at the Chantal BIYA International Reference Centre, Yaoundé, Cameroon from January 2020 through August 2021.

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Article Synopsis
  • Key populations (KP), which are crucial in addressing HIV, represent 70% of new infections globally and are the focus of a study examining drug resistance related to PrEP failure in sub-Saharan Africa.
  • The research will systematically review various studies to determine the prevalence of HIV drug resistance (HIVDR) among these populations after PrEP failure, analyzing data from diverse groups including gay men, sex workers, and people who inject drugs.
  • Findings aim to identify the rates of PrEP failure and drug resistance, helping improve HIV prevention strategies and inform medical practices for effective antiretroviral use in KP within sub-Saharan Africa.
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Background: The elevated rate of AIDS-related mortality in Sub-Saharan Africa among adolescents living with HIV (ALHIV) is influenced by various factors, notably immunosuppression, within a framework of limited therapeutic alternatives. We aimed to enhance the management of pediatric HIV by assessing the immune response and associated factors in perinatally-infected ALHIV on antiretroviral therapy (ART) in Cameroon.

Methods: A cohort study was conducted from 2018-2020 among 271 ART-experienced ALHIV in Cameroon.

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Article Synopsis
  • Mortality in children accounts for 15% of global AIDS-related deaths, with Cameroon facing a higher rate of 25%, mainly due to poor viral response.
  • A study analyzed viral suppression (VS) among Cameroonian children and young adults receiving antiretroviral therapy (ART) to identify factors affecting VS, finding an overall rate of 82.3%.
  • Key findings revealed that younger age, longer ART duration, and certain non-DTG-based regimens were independent predictors of non-VS, suggesting the need for prioritizing transition to DTG-based regimens to improve outcomes.
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As of December 2022, Cameroon had observed a slight resurgence of COVID-19, raising concerns on genomic surveillance of related-SARS-CoV-2 variants under circulation. Following a laboratory-based survey, positive SARS-CoV-2 samples detected from December-2022 through March-2023 were processed for targeted sequencing at the Chantal BIYA International Reference Centre (CIRCB) in Yaoundé-Cameroon. From all positive cases detected, 13 were successfully sequenced (mean age 34 years, 70% female); the majority of the cases were unvaccinated (70%, 9/13) and symptomatic (92%, 12/13); all with flu-like symptoms (100%, 12/12).

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  • - WHO suggests COVID-19 antigen rapid tests should have at least 80% sensitivity and 97% specificity, and this study evaluates the INDICAID™ Ag-RDT against RT-PCR as the gold standard, focusing on Omicron variants.
  • - The study involved 565 nasopharyngeal swabs, revealing that for samples with higher viral loads (CT < 25), INDICAID™ displayed 100% sensitivity, while still maintaining high specificity and good predictive values.
  • - The findings indicate that INDICAID™ Ag-RDT is highly effective for diagnosing COVID-19 in individuals with high viral loads, making it a practical tool for community-level prevention amidst the prevalence of Omicron subvariants.
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  • Surveillance of SARS-CoV-2 variants is essential for public health decisions, with a study focusing on their dynamics in Cameroon from April 2020 to August 2022.
  • The research involved analyzing SARS-CoV-2 positive samples using Sanger sequencing and SNPsig® SARS-CoV-2 EscapePLEX to evaluate their effectiveness in detecting variants.
  • Results showed a shift in dominant variants across different waves, with significant prevalence of the Omicron variant in the latest wave, indicating that SNPsig® is a reliable tool for variant detection, although improvements are needed for identifying Omicron sub-lineages.
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Background: With the advent of antiretroviral therapy (ART), most children living with HIV in sub-Saharan Africa (SSA) are growing toward adolescence, with scarcity of evidence on the size of viral reservoirs to enhance paediatric cure research strategies. This study aims to compare HIV-1 proviral DNA levels according to virological response among adolescents living with perinatally acquired HIV-1 (ALPHIV) and identify associated-factors in the Cameroonian context.

Methods: In this observational cohort study, HIV-1 RNA viremia and CD4 T-cell count were assessed through RT-PCR and flow cytometry respectively at three time-points over 18 months of observation.

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  • There has been an increase in Monkeypox (Mpox) cases globally, prompting a study on healthcare workers' understanding of its transmission, prevention, and response in Cameroon.
  • An online survey was conducted with 342 healthcare workers, revealing that while over 90% were aware of Mpox, only 12.9% had excellent knowledge and 42.1% had good knowledge of the disease.
  • The findings suggest a need for capacity-building programs to enhance healthcare workers' education on Mpox to ensure effective response to this and similar emerging diseases.
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Background: Postoperative pain management following minimally invasive repair of pectus excavatum (MIRPE) remains a critical concern due to severe post-procedural pain. Promising results have been reported for cryoanalgesia following MIRPE; however, its invasiveness, single-lung ventilation, and additional instrumentation requirements remain obstacles. Serratus anterior plane block (SAPB) is a regional block technique capable of covering the anterior chest wall at the T2-9 levels, which are affected by MIRPE.

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  • The study aimed to systematically review HIV-1 reservoirs in children and adolescents with perinatally acquired HIV, analyzing published data from various studies between 2002 and 2022.
  • A total of 49 studies involving over 2,300 participants were included, revealing a high prevalence of archived-drug resistance mutations (ADRMs) across different regions, with significant findings regarding early antiretroviral therapy (ART) initiation impacting HIV-1 DNA levels.
  • The conclusions emphasized that high ADRM prevalence and larger viral reservoirs are associated with late ART initiation and shorter periods of viral suppression, suggesting the need for early ART strategies in pediatric populations to improve treatment outcomes.
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Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is a lifesaving technique for patients experiencing respiratory failure. When VV ECMO fails to provide adequate support despite optimal settings, alternative strategies may be employed. One option is to add another venous cannula to increase venous drainage, while another is to insert an additional arterial return cannula to assist cardiac function.

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Acquired drug resistance (ADR) is common among adolescents living with perinatal HIV (APHI) in sub-Saharan Africa (SSA). Personalized management has the potential to improve pediatric antiretroviral therapy (ART), even in the presence of long-term treatment and HIV-1 subtype diversity. We sought to evaluate the effect of HIV-1 mutational profiling on immuno-virological response and ADR among APHI.

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  • The study investigates the impact of high-risk human papillomavirus (HR-HPV) on cervical lesions in women in Cameroon, particularly focusing on the differences between those who are HIV positive and those who are HIV negative.
  • Out of 257 women examined, 71.59% were found to be HIV positive, and the prevalence of HR-HPV was significantly higher in HIV-positive individuals (41.98%) compared to HIV-negative individuals (25.71%).
  • The findings suggest that HR-HPV is a strong independent factor in the development of cervical lesions, with HIV-positive women showing higher odds of developing these lesions compared to those who are only HPV positive.
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Objective: We sought to evaluate the variability of HIV-1 and its effect on immuno-virological response among adolescents living with perinatally acquired HIV (APHI).

Methods: A cohort study was conducted from 2018-2020 among 311 APHI receiving antiretroviral therapy (ART) in Cameroon. Sequencing of protease and reverse transcriptase regions was performed for participants experiencing virological failure, VF, (Plasma viral load, PVL ≥ 1000 RNA copies/ml).

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Introduction: The success of antiretroviral therapy (ART) has changed HIV from a deadly to a chronic infection, thus increasing the transitioning from infancy toward adulthood. However, the virostatic nature of antiretrovirals maintains viruses in sanctuaries, with reactivation potentials. Because current ARTs are very limited for children, the emergence of new HIV epidemics driven by HIV drug-resistance mutations is favoured.

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  • Non-pharmaceutical interventions, like hygiene measures and lockdown adherence, were assessed in a survey of 971 respondents in Yaounde, Cameroon, focusing on COVID-19 preventive practices and SARS-CoV-2 exposure through IgG tests from October to November 2020.
  • The survey revealed that hygiene rules were largely followed (93.8%), while only 49.1% adhered to the "stopped work" measure, with women generally showing higher compliance to preventive practices than men.
  • Notably, 31.1% tested positive for SARS-CoV-2, with men having a higher exposure rate, and many participants viewed healthcare facilities as high-risk locations, contributing to low rates of medical consultations and testing.
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Antiretroviral therapy (ART) has improved the lifespan of people living with HIV. However, their immune system remains in a state of sustained activation/inflammation, which favors viral replication and depletion of helper T-cells with varying profiles according to ART-response. We herein sought to ascertain the inflammatory profile of adolescents living with perinatal HIV-1 infection (ALPHI) receiving ART in an African context.

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Background: Sub-Saharan Africa (SSA) carries the highest burden of high-risk human papillomavirus (HR-HPV) in the world, driven by, and together with, HIV infection. This systematic review aimed to identify HR-HPV genotypes and their associated factors among women in SSA.

Methods: A systematic review and meta-analysis of studies conducted in SSA on HR-HPV was conducted.

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  • The study investigates the prevalence of oral candidiasis among people living with HIV (PLHIV) in Cameroon, differentiating between those on antiretroviral treatment (ART) and those who are ART-naive.
  • Results show a significantly higher occurrence of oral candidiasis in ART-naive patients (27.7%) compared to ART-experienced patients (6.3%), indicating a strong link between ART use and decreased incidence.
  • The findings highlight that immunodeficiency (CD4<200 cells/mm) and high viral loads (VL≥1000 copies/ml) contribute to the presence of oral candidiasis, emphasizing the need for management strategies for those experiencing immuno-virological failure.
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This study aimed to compare viral suppression (VS) between children, adolescents, and adults in the frame of transition to dolutegravir (DTG)-based antiretroviral therapy (ART) in the Cameroonian context. A comparative cross-sectional study was conducted from January 2021 through May 2022 amongst ART-experienced patients received at the Chantal BIYA International Reference Centre in Yaounde-Cameroon, for viral load (VL) monitoring. VS was defined as VL < 1000 copies/mL and viral undetectability as VL < 50 copies/mL.

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In order to limit the emergence of human immunodeficiency virus (HIV) drug resistance in a context of limited antiretroviral options, we sought to evaluate the efficacy of third-line (3L) regimens considering HIV genotypic resistance profile at initiation of 3L in Cameroon. A cohort-study was conducted from January-September 2020 among patients initiating a 3L antiretroviral therapy regimen at the Yaoundé Central Hospital. HIV-1 protease-reverse transcriptase was sequenced at the Chantal Biya international reference center for research on HIV/AIDS prevention and management and results were interpreted using Stanford HIVdbv8.

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Background: Pre-eclampsia may be associated with the development of endometrial cancer; however, previous findings have been conflicting.

Objectives: To investigate if pre-eclampsia is associated with an increased risk of endometrial cancer.

Method: Two independent reviewers screened titles and abstracts of studies identified in MEDLINE, Embase, and Web of Science databases from inception until March 2022.

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Article Synopsis
  • The study examined the prevalence of SARS-CoV-2 antibodies in Cameroon before the COVID-19 pandemic, focusing on HIV-positive and HIV-negative individuals using 288 stored plasma samples.
  • Results showed an overall seropositivity of 13.5%, with a slightly lower rate among HIV-positive individuals (11.0%) compared to HIV-negative individuals (16.8%).
  • Additionally, higher CD4 counts and lower viral loads in people living with HIV were associated with increased seropositivity to SARS-CoV-2 antibodies, suggesting possible cross-immunity in tropical regions.
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