Fokam, J. | Search bioRxiv

bioRxiv2020

Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

BackgroundHIV management remains concerning and even more challenging in the frame of comorbidities like malnutrition that favors disease progression and mortality in resource-limited settings (RLS). ObjectiveTo evaluate the correlation between immuno-virological responses and the nutritional profile of HIV-infected individuals receiving antiretroviral therapy (ART). MethodsA cross-sectional study was conducted from October to December 2018 among 146 consenting participants enrolled in two health facilities of the East-Region of Cameroon. Socio-demographic data, basic clinical information and treatment history were collected; blood samples were collected by venipuncture for laboratory analysis (HIV-1 viral load, CD4-CD8 Tcells measurement and biochemical analysis) performed at the "Chantal Biya" International Reference Center", Yaounde, Cameroon. Nutritional profile was evaluated using anthropometric and biochemical parameters. Data were analyzed using Excel 2016, Graph pad prism version 6 and R.version3.5.0; Spearman correlation was used; with p<0.05 considered statistically significant. ResultsMedian [IQR] age was 42 [33-51] years, 76.0% (111/146) were female and median [IQR] duration on ART was 54 [28-86] months. Of these participants, 11.6% (17/146) were underweight based on the body mass index and 4.7% (7/146) were at the stage of advanced weight loss. According to immunovirological responses, 44.5% (65/146) were immunocompromised (CD4<500 cell/{micro}l) and 75.3% (110/146) had an undetectable viremia (<40 copies/mL). CD4 count inversely correlated with total protein concentration (r=-0.18, p=0.030) and viremia was inversely correlated with total cholesterol (r=-0.65; p=0.001), and positively correlated with total protein (r=0.28; p<0.001) and seemingly with triglycerides (r=0.27; p=0.070) concentrations. ConclusionIn this RLS with patients having about five years of ART-experience, half are immunocompromised while the majority have achieved good virological response. Interestingly, one out of eight patients might be experiencing malnutrition. Specifically, increasing CD4 may favour hypo-proteinemia while increasing viral load may prone hyper-proteinemia and hypo-cholesterolemia. Further studies are needed in RLS with high burden of HIV-infection.

microbiology↗

bioRxiv2018

Factors Associated with Risk Of HIV-Infection Among Pregnant Women in Cameroon: Evidence from the 2016 National Sentinel Surveillance Survey of HIV and syphilis

BackgroundHuman Immunodeficiency Virus infection (HIV) remains a public health concern in Cameroon that requires regular surveillance for informed policy-making to guide programmatic interventions. Using data from the 2016 HIV national sentinel survey in Cameroon, we ascertained HIV prevalence and factors associated with risk of infection among pregnant women\n\nMethodsA cross-sectional study was conducted throughout 2016 in the 10 regions of Cameroon, targeting 7000 first antenatal care (ANC-1) attendees (4000 from urban and 3000 from rural areas) in 60 sentinel health facilities. HIV serological test was performed using the national serial algorithm at the National Reference Laboratory (NRL). Prevalence was determined, and multivariate logistic regression was used to assess determinants of HIV infection, with p-value<0.05 considered statistically significant.\n\nResultsOf the 7000 targeted participants, a total of 6859 first ANC-1 attendees were enrolled (98.0% sampling coverage). Median age was 26 [IQR: 21-30] years and 47,40% had a secondary school level of education. The national prevalence of HIV was 5.70% (95% CI: 4.93 - 6.40) and range from 9.7% in East region to 2.6% in North region. The prevalence was 5.58% (95% CI: 95%: 4.88 - 6.35) in urban and 5.87% (95% CI: 5.04 - 6.78) in rural settings. Factors that were associated with HIV infection included marital status, women who were married or living with their partner are less likely to be infected than singles women (aOR=0.60; 95% CI: 0.46 - 0.78), multiparity [aOR=1.5(95%CI:1.0-2.2)] and been living in the Centre, East, North-west and South-west regions. HIV infection was also significantly associated with age, with the risk of being infected increasing with age.\n\nConclusionPregnant women in Cameroon are still disproportionately infected with HIV compared with the general population (prevalence 4.3%). Preventive actions to curb the epidemic amongst pregnant women should prioritize interventions targeting single pregnant women, who are older, and residing particularly in the Centre, East, North West and South West regions of the country.

epidemiology↗