RESUMEN

OBJECTIVES: To characterize the genetic diversity and drug resistance profiles of people with HIV-1 failing ART in Cape Verde (CV). DESIGN: Cross-sectional study conducted between January 2019 and December 2021 in 24 health centres on the islands of Santiago and São Vicente. METHODS: The HIV-1 pol gene was sequenced in individuals with a detectable viral load. HIV-1 genetic diversity was determined by phylogenetic analysis. Drug resistance mutation patterns and resistance phenotypes were estimated using the Stanford algorithm. RESULTS: Viral load was detected in 73 of 252 (29%) enrolled participants and sequencing data were produced for 58 (79%) participants. CRF02 AG strains predominated (46.5%), followed by subtype G (22.4%). Most patients (80%) had mutations conferring resistance to nonnucleoside reverse transcriptase inhibitors (NNRTIs) (67%), nucleoside reverse transcriptase inhibitors (55%), integrase inhibitors (10%) and/or protease inhibitors (7%) used in Cape Verde, a significant increase compared with a study conducted in 2010-2011. The most common mutations were M184V/I (43%), K103N/S (36%) and G190A/S (19%). NNRTI resistance was associated with younger age and exposure to two or more drug regimens. CONCLUSION: The HIV-1 epidemic in Cape Verde is mainly driven by CRF02_AG and subtype G. Resistance to NNRTIs and/or NRTIs is highly prevalent and resistance to LPV/r and DTG is emerging. Our results support the use of DTG-based first-line ART and protease inhibitor-based regimens for patients with virological failure, but emerging resistance to LPV/r and DTG is a concern. Continued monitoring of drug resistance is essential to ensure adequate healthcare for PWH in Cape Verde.

Asunto(s)

Farmacorresistencia Viral , Variación Genética , Infecciones por VIH , VIH-1 , Filogenia , Humanos , VIH-1/genética , VIH-1/efectos de los fármacos , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/virología , Masculino , Farmacorresistencia Viral/genética , Femenino , Estudios Transversales , Adulto , Cabo Verde , Persona de Mediana Edad , Fármacos Anti-VIH/uso terapéutico , Fármacos Anti-VIH/farmacología , Carga Viral , Adulto Joven , Genotipo , Mutación , Adolescente , Productos del Gen pol del Virus de la Inmunodeficiencia Humana/genética

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Zika virus (ZIKV) diagnostics are crucial for proper antenatal and postnatal care and also for surveillance and serosurvey studies. Since the viremia during ZIKV infection is fleeting, serological testing is highly valuable to inform diagnosis. However, current serology tests using whole virus antigens frequently suffer from cross reactivity issues, delays, and technical complexity, especially in low and middle income countries (LMICs) and endemic countries. Here, we describe an indirect ELISA to detect specific IgG antibodies using the ZIKV envelope domain III (EDIII) protein expressed in Drosophila S2 cells as an immunogen. Using a total of 367 clinical samples, we showed that the EDIII-ELISA was able to detect IgG antibodies against ZIKV with high sensitivity of 100.0% and specificity of 94.7% when compared to plaque reduction neutralization tests (PRNTs) as the gold standard and using 0.208 as the cut-off OD value. These results show the usefulness of the recombinant envelope domain III as an alternative to standard whole virus proteins for ZIKV diagnostics as it improves the sensitivity and specificity of IgG ELISA assay when used as an immunogen. This method should, therefore, be extended to serological diagnostic techniques for other members of the flavivirus genus and for use in IgM diagnostic testing.

RESUMEN

CONTEXT: The first case of COVID-19 in Cabo Verde was confirmed on March 19, 2020. Since the beginning of the pandemic in the country, the government and health authorities have adopted restrictive measures to prevent the spread of SARS-CoV- 2 and well as defined risk communication and community involvement strategies. The present study aimed at assessing the knowledge, attitudes, and practices of the Cape Verdean resident population towards COVID-19, to support the government and the national health system in the definition of public health policies related to COVID-19. METHOD: A cross-sectional study was conducted among 1996 participants aged 16 years old and above. Data collected from April 5 to April 12, 2020, via an online self-reporting questionnaire adapted from a Chinese study. Descriptive statistics, chi-square tests, simple and multiple linear regression analyses were performed to determine factors associated with knowledge, attitudes, and practices towards COVID-19. RESULTS: The overall correct answer rate related to the knowledge about COVID-19 was 82% (9/11 * 100), 1970 (98.70%) of the participants declared they had stayed at home in recent days, 1926 (96.49%) had not attended parties, funerals or crowded places and 1860 (93.19%) confirmed changes in daily routines due to COVID-19. The majority of the participants, 1797 (90.26%), preferred receiving information about COVID-19 in Portuguese and trusted information transmitted by health professionals. Furthermore, television, radio, and newspapers were the preferred means of transmitting information about COVID-19. Participants' knowledge influenced COVID-19 prevention and control practices (rho = 0.119; p = 0.000). CONCLUSIONS: These findings showed that the resident population had a good level of knowledge about COVID-19; however, there is a need to use more effective strategies to improve attitudes and practices towards COVID-19 to attain better results in controlling the pandemic in Cabo Verde.