Determination of HIV Drug Resistance Among Children and Mothers Enrolled in Progr

摘要/摘要。 在喀麦隆，艾滋病毒普遍流行，估计流行率为5.1%， 以非常高的遗传多样性为特点。事实上，到目前为止，这一流行病是由所有艾滋病毒推动的 亚型包括循环重组形式(CRF)、独特重组形式(URF)和 高度分化的菌株，如O、N和P群。高度多样性对 喀麦隆艾滋病毒耐药性的出现还没有得到很好的研究。2010年，覆盖范围 母婴传播的比例为22.2%，16.0%的感染儿童接受了抗逆转录病毒治疗 全国范围内。喀麦隆的有限研究报告了与原发耐药性相关的突变 在接受抗逆转录病毒治疗(ART)的人中，主要是逆转录酶(RT)和 蛋白酶抑制剂。喀麦隆浸信会卫生委员会(CBCHB)目前 支持全国427个地点预防母婴传播 防止母婴传播(PMTCT)计划，其中240个是政府设施。到目前为止，CBCHB已经咨询了450人， 231名妇女，在这些设施检测了428,370人(95.1%)(艾滋病毒流行率为10.7%)。 在很大程度上归功于CBCHB的努力，孕产妇和婴儿的抗逆转录病毒治疗接受率在#年有所增加。 喀麦隆从2000年的37.7%上升到2009年的96.6%。这项研究的目标是确定 在18个月大的儿童中耐药艾滋病毒的流行率，并评估 巨大的HIV基因多样性对中国人群耐药突变发生的影响 喀麦隆的防止母婴传播方案。最初为早期收集的剩余干渍斑点标本 这项研究将使用婴儿诊断。这项研究的结果将有助于决策 关于喀麦隆预防母婴传播方案的一线抗逆转录病毒药物方案，并将提供 更好地了解艾滋病毒广泛的遗传多样性和发生之间的联系 耐药突变。它还将有助于全球努力应对新出现的 艾滋病毒抗药性。

Abstract / Summary. In Cameroon the HIV epidemic is generalized with an estimated prevalence of 5.1%, and characterized by a very high genetic diversity. Indeed, to date the epidemic is driven by all HIV subtypes including circulating recombinant forms (CRF), unique recombinant forms (URF), and highly divergent strains such as groups O, and N and P. The impact of the high diversity on the emergence of HIV drug resistance in Cameroon has not been well studied. In 2010, the coverage of the PMTCT was 22.2% with 16.0% of infected children receiving antiretroviral treatment nationwide. Limited studies in Cameroon reported primary resistance-associated mutations among antiretroviral therapy (ART) drug-na¿ve persons, mainly to reverse transcriptase (RT) and protease inhibitors. The Cameroon Baptist Convention Health Board (CBCHB) currently supports 427 sites all over the country for the Prevention of Mother-to-Child Transmission (PMTCT) program, of which 240 are government facilities. To date, CBCHB has counseled 450, 231 women and tested 428, 370 (95.1%) at these facilities (with an HIV prevalence of 10.7%). Thanks largely to the CBCHB efforts, maternal and infant ART uptake rates have increased in Cameroon from 37.7% in 2000 to 96.6% in 2009. The goal of this study is to determine the prevalence of drug-resistant HIV among children < 18 months of age, and also evaluate the impact of the enormous HIV genetic diversity on the occurrence of drug-resistant mutations in PMTCT programs in Cameroon. Leftover dried blot spot specimens collected originally for early infant diagnosis will be used in this study. The outcome of this study will assist decision-making on first-line antiretroviral drug regimens for the PMTCT program in Cameroon and will provide a better understanding of the association of the extensive HIV genetic diversity and occurrence of resistant mutations. It will also contribute to the global effort to respond to the emergence of HIV drug resistance.