HIV Serodiscordance among Couples in Cameroon: Effects on Sexual and Reproductive Health.

BACKGROUND AND OBJECTIVES: One of the main reasons for risky sexual behavior observed in HIV serodiscordant couples despite the knowledge of the partner's status and counselling is childbearing. In Cameroon, there are few reports on HIV serodiscordant couples. This paper describes the influence of HIV on sexual relationships and decision to procreate. METHODS: This cross-sectional study was conducted in five health centers. Self-administered questionnaire was used to collect social and demographic information, while semi-structured in-depth individual and couple interviews were used to explore sexual relationships and decisions about fatherhood/motherhood. Blood samples were collected from the couples and tested for HIV to confirm serodiscordance. The data were analyzed using the GraphPad Prism Version 6 software. RESULTS: A total of 53/192 (27.6%) HIV serodiscordant couples participated in the study, and 18/74 (24.32%) HIV positive seroconcordant couples and 32/80 HIV negative seroconcordant couples were used as controls. The majority of HIV-positive partners in serodiscordant couples were women (30/53), of whom 25/30 were on antiretroviral therapy. Nearly half of the respondents (23 /53) reported tensions related to serodiscordance, shown by reduced sex frequency. The use of condoms was not systematically observed among seroconcordant and serodiscordant couples with respective proportions of 55.55% and 20.75% (p = 0.0086). Thirty seven out of 53 HIV serodiscordant couples wanted children, among them, seven couples did not have any and expressed their aspiration for parenthood despite fear of infecting one's partner. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Sexuality of serodiscordant couples as well as of HIV positive seroconcordant couples was affected by the presence of HIV/AIDS. The desire to procreate may lead couples to adopt risky sexual behaviors. It is important to define specific guidelines for serodiscordant couples in order to improve their sexual life and consequently enable them to procreate with minimal risk of infecting their partner and or to transmit the virus to their baby.

TRIM5α 136Q, CCR5 Promoter 59029G And CCR264I Alleles Impact The Progression Of HIV In Children And Adolescents.

BACKGROUND: Children show various degrees of vulnerability regarding HIV infection and disease progression. This disparity presents challenges for the follow-up of infected children. Here we investigated reasons behind this variability focusing on some host-related HIV genes. METHODS: We screened 570 Cameroonian children and adolescents, aged 1 to 19 years old. Among them, 137 were followed over 4 years, from 2010 to 2015. Upon signing a proxy consent, children and adolescents were classified according to their age, CD4 count, viral load and clinical symptoms as long-term non-progressors (LTNP), slow progressors (SP) and rapid progressors (RP). Their blood was collected every 6 months and used for biological and host genetic polymorphism analyses. Five genes were genotyped: Trim5α (R136Q), CCR5 promoter 59029G, CCR2-64I, SDF 3'A and CCR5-Δ32. Exposed non-infected (HEU) and unexposed HIV negative children (HNEU) were recruited as control groups. RESULTS: Among the 5 genes studied, the protective allele of Trim5α (R136Q) was present in all LTNP and in 72.34% and 2.56% of SP and RP, respectively (p<0.0001). The CCR5 promoter 59029G/G was also more present in LTNP and SP than in RP (p=0.02; p=0.04). The protective CCR2-64I homozygous genotype was almost absent in all groups, only the heterozygous genotype was present with a significant difference between RP vs SP (p=0.0001), and SP vs LTNP (p=0.0002). The CCR2-∆32 was completely absent either as homozygous or heterozygous genotype. It was a monomorphic allele. SDF 3'A was almost present as homozygous wild-type genotype in our study population and was associated neither to disease acquisition nor to disease progression. CONCLUSION: Among the 5 genes described in the study, Trim 5α (R136Q), CCR5 promoter 59029G and CCR2V64I alleles were associated to the progression of HIV infection in children and adolescents.

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.

Host Molecular Factors and Viral Genotypes in the Mother-to-Child HIV-1 Transmission in Sub-Saharan Africa.

Maternal viral load and immune status, timing and route of delivery, viral subtype, and host genetics are known to influence the transmission, acquisition and disease progression of human immunodeficiency virus-1 (HIV-1) infection. This review summarizes the findings from published works on host molecular factors and virus genotypes affecting mother to child transmission (MTCT) in Africa and identifies the gaps that need to be addressed in future research. Articles in PubMed, Google and AIDSearch and relevant conference abstracts publications were searched. Accessible articles on host factors and viral genetics impacting the MTCT of HIV, done on African populations till 2015 were downloaded. Forty-six articles were found and accessed; 70% described host genes impacting the transmission. The most studied gene was the CCR5 promoter, followed by the CCR2-64I found to reduce MTCT; then SDF1-3'A shown to have no effect on MTCT and others like the DC-SIGNR, CD4, CCL3 and IP-10. The HLA class I was most studied and was generally linked to the protective effect on MTCT. Breast milk constituents were associated to protection against MTCT. However, existing studies in Sub Saharan Africa were done just in few countries and some done without control groups. Contradictory results obtained may be due to different genetic background, type of controls, different socio-cultural and economic environment and population size. More studies are thus needed to better understand the mechanism of transmission or prevention.