{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:09:39Z","timestamp":1793120979475,"version":"4.5.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T00:00:00Z","timestamp":1698192000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["TMA 1027"],"award-info":[{"award-number":["TMA 1027"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We sought to evaluate the variability of HIV-1 and its effect on immuno-virological response among adolescents living with perinatally acquired HIV (APHI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cohort study was conducted from 2018\u20132020 among 311 APHI receiving antiretroviral therapy (ART) in Cameroon. Sequencing of protease and reverse transcriptase regions was performed for participants experiencing virological failure, VF, (Plasma viral load, PVL \u2265 1000 RNA copies\/ml). HIV-1 subtypes were inferred by phylogeny; immuno-virological responses were monitored at 3-time points (T1-T3). Cox regression modeling was used to estimate adjusted hazard ratios (aHRs) of progression to: CD4 &lt; 250, and PVL &gt; 5log\n                      <jats:sub>10<\/jats:sub>\n                      , adjusted for acquired drug resistance, gender, ART line, adherence, and duration on treatment; p &lt; 0.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 141 participants in VF enrolled, the male-female ratio was 1:1; mean age was 15 (\u00b13) years; and median [IQR] duration on ART was 51 [46\u201360] months. In all phases, 17 viral clades were found with a predominant CRF02_AG (58.2%, 59.4%, and 58.3%). From T1-T3 respectively, there was an increasing CD4 count (213 [154\u2013313], 366 [309\u2013469], and 438 [364\u2013569] cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      ) and decline log\n                      <jats:sub>10<\/jats:sub>\n                      PVL (5.23, 4.43, and 4.43), similar across subtypes. Among participants with CRF02_AG infection, duration of treatment was significantly associated with both rates of progression to CD4 &lt; 250, and PVL &gt; 5log\n                      <jats:sub>10<\/jats:sub>\n                      , aHR = 0.02 (0.001\u20130.52), and aHR = 0.05 (0.01\u20130.47) respectively. Moreover, four potential new HIV-1 recombinants were identified (CRF02_AG\/02D, CRF02_AG\/02A1F2, D\/CRF02_AG, and AF2\/CRF02_AG), indicating a wide viral diversity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among APHI in settings like Cameroon, there is a wide genetic diversity of HIV-1, driven by CRF02_AG and with potential novel clades due to ongoing recombination events. Duration of treatment significantly reduces the risk of disease progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0293326","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T13:34:44Z","timestamp":1698240884000},"page":"e0293326","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["HIV-1 subtype diversity and immuno-virological outcomes among adolescents failing antiretroviral therapy in Cameroon: A cohort study"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5194-6715","authenticated-orcid":true,"given":"Willy Le roi","family":"Togna 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