{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:14:22Z","timestamp":1790374462204,"version":"4.1.0"},"reference-count":32,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T00:00:00Z","timestamp":1687910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chantal BIYA International Reference Center for Research on HIV and AIDS Prevention and Management (CIRCB)","award":["PTA 2014-2021"],"award-info":[{"award-number":["PTA 2014-2021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The efficacy of first-line antiretroviral therapy (ART) may be hampered by the presence of HIV drug resistance (HIVDR). We described HIV-1 pre-treatment drug resistance (PDR) patterns, effect of viral clades on PDR, and programmatic implications on first-line regimens in Cameroon. A sentinel surveillance of PDR was conducted from 2014 to 2019. Sequencing of HIV-1 protease and reverse transcriptase was performed, and HIVDR was interpreted using Stanford HIVdb.v.9.4. In total, 379 sequences were obtained from participants (62% female, mean age 36 \u00b1 10 years). The overall PDR rate was 15.0% [95% CI: 11.8\u201319.0] nationwide, with significant disparity between regions (p = 0.03). NNRTI PDR was highest (12.4%), of which 7.9% had DRMs to EFV\/NVP. Two regions had EFV\/NVP PDR above the 10% critical threshold, namely the Far North (15%) and East (10.9%). Eighteen viral strains were identified, predominated by CRF02_AG (65.4%), with no influence of genetic diversity PDR occurrence. TDF-3TC-DTG predictive efficacy was superior (98.4%) to TDF-3TC-EFV (92%), p &lt; 0.0001. The overall high rate of PDR in Cameroon, not substantially affected by the wide HIV-1 genetic diversity, underscores the poor efficacy of EFV\/NVP-based first-line ART nationwide, with major implications in two regions of the country. This supports the need for a rapid transition to NNRTI-sparing regimens, with TDF-3TC-DTG having optimal efficacy at the programmatic level.<\/jats:p>","DOI":"10.3390\/v15071458","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T00:25:21Z","timestamp":1687911921000},"page":"1458","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Pre-Treatment HIV Drug Resistance and Genetic Diversity in Cameroon: Implications for First-Line Regimens"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1501-2763","authenticated-orcid":false,"given":"Joseph","family":"Fokam","sequence":"first","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Faculty of Health Science, University of Buea, Buea P.O. Box 0063, Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"},{"name":"National HIV Drug Resistance Prevention and Surveillance Working Group, Ministry of Public Health, Yaound\u00e9 P.O. Box 3038, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6749-1436","authenticated-orcid":false,"given":"Collins Ambe","family":"Chenwi","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"},{"name":"Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e8re","family":"Tala","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e9sir\u00e9","family":"Takou","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6228-1114","authenticated-orcid":false,"given":"Maria Mercedes","family":"Santoro","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Teto","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Dambaya","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Anubodem","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezechiel Ngoufack Jagni","family":"Semengue","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"},{"name":"Faculty of Sciences and Technologies, Evangelical University of Cameroon, Bandjoun P.O. Box 0127, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Beloumou","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Djupsa","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Assomo","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Fokunang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4270-5079","authenticated-orcid":false,"given":"Claudia","family":"Alteri","sequence":"additional","affiliation":[{"name":"Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Billong","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"},{"name":"National HIV Drug Resistance Prevention and Surveillance Working Group, Ministry of Public Health, Yaound\u00e9 P.O. Box 3038, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nounouce Pamen","family":"Bouba","sequence":"additional","affiliation":[{"name":"Department of Disease, Epidemic and Pandemic Control, Ministry of Public Health, Yaounde P.O. Box 3038, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rogers","family":"Ajeh","sequence":"additional","affiliation":[{"name":"Central Technical Group, National AIDS Control Committee, Yaound\u00e9 P.O. Box 2005, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Colizzi","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"},{"name":"Faculty of Sciences and Technologies, Evangelical University of Cameroon, Bandjoun P.O. Box 0127, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dora","family":"Mbanya","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"},{"name":"National Blood Transfusion Service, Ministry of Public Health, Yaound\u00e9 P.O. Box 3038, Cameroon"},{"name":"Haematology and Transfusion Service, Centre Hospitalier et Universitaire (CHU), Yaound\u00e9 P.O. Box 30335, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Ceccherini-Silberstein","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo-Federico","family":"Perno","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Bambino Gesu\u2019 Children\u2019s Research Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Ndjolo","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management, Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,28]]},"reference":[{"key":"ref_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (2021, February 02). Global and Regional Statiatics\u20142018. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/UNAIDS_FactSheet_en.pdf."},{"key":"ref_2","unstructured":"Joint United Nations Programme on HIV\/AIDS (2021, February 02). Countries Statistics\u20142018. Available online: https:\/\/www.unaids.org\/fr\/regionscountries\/countries\/cameroon."},{"key":"ref_3","unstructured":"WHO (2021, February 02). Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection\u2014Recommendations for a Public Health Approach\u2014Second Edition. 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