Differential expression of Fas receptors (CD95) and Fas ligands (CD95L) in HIV infected and exposed uninfected children in Cameroon versus unexposed children.

INTRODUCTION: The number of HIV exposed uninfected (HEU) infants is increasing as vertical transmission is reducing. This subpopulation requires more investigations. This study aimed at comparing the expression level of soluble Fas receptors (FasR) and ligands (FasL) between HIV infected, HEU and unexposed children. METHODS: Eighty eight HIV-1infected, 86 HEU and 38 HIV unexposed children were recruited. Soluble FasR and FasL were measured in their plasma. Mann-Whitney U-Test was used to compare groups with 95% confidence. Spearman coefficient was used to test the correlation with CD4 and viral load (VL). RESULTS: Overall plasma levels of FasR were higher than that of FasL. The concentration of FasR and FasL were significantly higher in HIV-1 infected children in comparison to HEU and unexposed children. There was no difference in the plasma level of FasL in HIV infected compared to HEU children. A significant difference was observed between HIV infected children and HEU children (P=0.001) for the FasL. FasR were higher in both HIV infected and unexposed children compared to HEU children. There was a positive correlation (rs=+0.4; p=0.01) in ARV treated children between CD4 count and FasL concentration. Significant negative correlation (rs=-0.3; p=0.040) in ARV naïve children was observed between CD4 percentage and FasL. Significant and positive correlation (rs=+0.4; p=0.008) was observed between the VL and FasL in HIV infected, treated or not. CONCLUSION: HEU children differ from HIV infected and unexposed children as the level of FasL/R expression is concerned. HEU should be considered different from HIV unexposed although exempt from virus as some immune dysfunctions have been reported among them.

Evaluation of OraQuick® HIV-1/2 as Oral Rapid Test.

As Cameroon scales up its national HIV/AIDS control program, evaluating the performance of commercially available tests for accurate and cost effective diagnostics becomes essential. A cross-sectional study assessed the performance of an HIV oral rapid test. A total of 1520 participants consented to participate in the study. After counselling, they were tested for HIV using the national algorithm followed by OraQuick. Results of the national algorithm were compared to those of OraQuick, for sensitivity, specificity, positive predictive and negative predictive values. 62% of participants were male, and 1% was reported HIV-positive following the national algorithm. The OraQuick test had 93% sensitivity, 99% specificity, 99.93% NPV and 90% PPV (95% CI, Kappa 0.965). Though more expensive (2-6x) compared to the national algorithm tests, oral mucosal transudate-based test demonstrated good performance. Therefore, it could be implemented in resource-constrained settings if subsidized and could increase participation since less invasive with no blood accident exposure.