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

摘要/总结。 在喀麦隆，艾滋病毒的流行很普遍，估计流行率为5.1%， 具有高度的遗传多样性。事实上，到目前为止，艾滋病是由所有艾滋病毒驱动的。 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组。 喀麦隆艾滋病毒抗药性的出现尚未得到充分研究。2010年，覆盖面 预防母婴传播的比例为22.2%，16.0%的受感染儿童接受了抗逆转录病毒治疗 全国范围喀麦隆的有限研究报告了原发性耐药相关突变 在抗逆转录病毒疗法（ART）药物初治者中，主要是逆转录酶（RT）， 蛋白酶抑制剂喀麦隆浸礼会卫生委员会目前 支持全国427个预防母婴传播的站点 （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名妇女在这些设施接受了检测，428 370人（95.1%）接受了检测（艾滋病毒感染率为10.7%）。 在很大程度上由于CBCHB的努力， 喀麦隆从2000年的37.7%上升到2009年的96.6%。本研究的目的是确定 18个月以下儿童中耐药性艾滋病毒的流行率，并评估 巨大的艾滋病毒遗传多样性对耐药突变发生的影响， 喀麦隆的预防母婴传播方案。早期采集的剩余干斑点标本 本研究将使用婴儿诊断。这项研究的结果将有助于决策 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 更好地了解广泛的艾滋病毒遗传多样性和发生率之间的关系， 耐药突变的证据。它还将有助于全球努力应对 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.