A decade of follow-up and therapeutic drug monitoring in HIV-2 immunocompromised patients at St Camille and General Lamizana Military Medical Centers, Burkina Faso, West Africa.

Although, HIV-2 is generally less pathogenic than HIV-1 and its progression towards AIDS occurs less frequently. HIV-2 remains an important cause of disease in West Africa. This study aimed to evaluate HIV-1 and HIV-2 prevalence among pregnant women and to describe the demographic and clinical profile of patients with HIV-2 infection from 2003-2013 at St Camille and General Lamizana Military Medical Centers. A retrospective investigation was conducted using 12,287 medical records from patients screened for HIV. To respond to the lack of data available regarding HIV-2 treatment and also to address the approach to clinical, biological as well as therapeutic monitoring, 62 HIV-2 infected patients' medical records were studied. Seroprevalence of 10.6 and 0.14% were obtained, respectively for HIV-1 and HIV-2 among 12,287 women screened during the study period. From the sixty two (62) HIV-2 patients, the average age was 49.2 years (sex ratio was 0.65). The weight loss and diarrhea were the major clinical manifestations observed, respectively 54.8 and 25.8%. Fungi and herpes zoster (shingles) infections were reported as major opportunistic infections. Also, nearly half of the patients had more than 60 kg, less than 2% were in WHO stage IV and about 2/3 had a CD4 count bellow 250 cells mm(-3). AZT-3TC-IDV/LPV/R was the most prescribed combination. The gain in weight gain the Body Mass Index (BMI) improvement and the non-significant increase of the rate of CD4 between 1st (M1) and 24th month (M24) were observed after treatment with antiviral.

[Molecular diagnosis of bacterial meningitis in Burkina Faso]. / Diagnostic moléculaire par PCR en temps réel d'agents bactériens responsables des méningites purulentes au Burkina Faso.

STUDY OBJECTIVES: The aim of this pilot study was to evaluate the use of real-time polymerase chain reaction (RT-PCR) in the diagnosis of bacterial meningitis in Burkina Faso. METHODOLOGY: This retrospective study reviewed the analyses of specimens collected from April 2009 through February 2010. DNA was extracted from cerebrospinal fluid (CSF) from patients with suspected meningitis from different health districts in Burkina Faso and analyzed with RT-PCR. Many patients were also tested with traditional diagnostic methods for meningitis: culture and serology (latex agglutination test). RESULTS: The study included 171 patients hospitalized in 8 health districts. Bacterial DNA for germs causing purulent meningitis was identified in 108/171 patients (63%); corresponding percentages for culture and latex were 60% (56/93) and 77% (66/86), respectively. All three methods found that NmA and Spn were the two main bacteria responsible for purulent meningitis in our cohort: with real time PCR, NmA = 59.3% and Spn = 34.3%), culture (NmA = 78.6% and Spn = 17.8%) or latex (NmA = 77.3% and Spn = 21.2%). Real-time PCR improved the sensitivity and the specificity of the diagnosis of the germs involved in this study and allowed the detection of the serogroups NmY and NmW135, which could not be detected by culture or latex agglutination test. RT-PCR permitted the detection and the characterization of bacteria responsible for purulent meningitis from CSF-contaminated cultures that could not otherwise be detected.

[Molecular diagnosis of acquired human immunodeficiency virus (HIV) in pooled plasma from blood donors at the Regional Blood Transfusion Center in Ouagadougou, Burkina Faso]. / Diagnostic moléculaire du virus de l'immunodéficience humaine acquise (VIH) sur les pools de plasmas de donneurs de sang au centre régional de transfusion sanguine de Ouagadougou (CRST-O), Burkina Faso.

STUDY OBJECTIVES: The aim of this pilot study was to investigate the use of viral genome diagnosis of HIV-1 infection in blood donors in the regional blood transfusion center in Ouagadougou, Burkina Faso. METHODOLOGY: This prospective study was carried out from August to December 2009 at the regional blood transfusion center in Ouagadougou (RBTC-O). Detection of HIV-1 was performed by RT-PCR on pooled plasma and individual samples from blood donors. Samples were selected based on reactivity with fourth generation ELISA. RESULTS: ELISA assays on 20 plasma pools demonstrated 10 negative samples, 8 positive and 2 undeterminable. All positive and negative ELISA tests were confirmed by RT-PCR. Findings of RT-PCR on individual samples confirmed those obtained on pooled plasma samples. For the two undeterminable pools, RT-PCR identified one as negative and the other as positive. Individual RT-PCR testing of donations contained in positive and negative pooled plasma samples confirmed negative or positive findings. CONCLUSIONS: Because of the high cost of RT-PCR, we recommend use first on minipools or individual samples from blood donors with questionable HIV-1 status to confirm status quickly and minimize loss of blood bags.