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Background Panzi General Reference Hospital (HGR Panzi) in the Democratic Republic of Congo follows a large number of patients living with HIV-1 (PLWHIV). Although antiretrovirals (ARVs) are available, HIV-1 viral load (HIV-VL) measurement has only been implemented in the hospital since 2018. No data on ARV resistance levels and ARV dosage in plasma have yet been published for this region. We determined the prevalence of virological failure due to ARV resistance amongst patients and assessed the degree of genotypic resistance of the viral strains. Methods We performed an HIV-VL test and determined dosage of ARVs on samples collected from 205 PLWHIV at HGR Panzi between 2017 and 2018, including 13 ARV-naive patients. Genotypic resistance testing was performed on all samples with detectable HIV-VLs, and interpreted with the Agence Nationale de Recherches sur le Sida (ANRS) 2018 algorithm. Results Baseline resistance to NNRTIs was found in 2 of the 13 treatment-naive individuals (15%). ARV dosage was non-optimal for 44/192 of treated patients (22.9%), with an HIV-VL ≥1000 IU/mL for 40/192 (20.8%) of them. In particular, treatment-experienced viruses presented resistance to at least one NRTI (52.5%), to at least one NNRTIs (70%) or to at least one PIs (15%). Finally, two samples contained viruses with resistance polymorphism in the integrase gene. Conclusions The high level of resistance to ARVs observed during this study, mainly due to treatment compliance default, fully justifies the implementation of means for closer patient monitoring. The provision of VL tests and therapeutic education management tools in a PLWHIV follow-up remains an absolute necessity to best adapt the current treatment lines in this region. [ABSTRACT FROM AUTHOR]

Objective: Data on the transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) remain conflicting. Airborne transmission is still debated. However, hospital risk control requires better understanding of the different modes of transmission. This study aimed to evaluate the frequency of, and factors associated with, environmental air and surface contamination in the rooms of patients with coronavirus disease 2019 in the acute phase of the disease.Methods: Sixty-five consecutive patients were included in this study. For each patient, seven room surfaces, air 1 m and 3 m from the patient's head, the inner surface of the patient's mask, and the outer surface of healthcare workers' (HCW) masks were sampled. Environmental contamination was assessed by quantitative reverse transcription polymerase chain reaction (RT-qPCR) for SARS-CoV-2 RNA on surfaces, air and masks. A viral isolation test was performed on Vero cells for samples with an RT-qPCR cycle threshold (Ct) ≤37.Results: SARS-CoV-2 RNA was detected by RT-qPCR in 34%, 12%, 50% and 10% of surface, air, patient mask and HCW mask samples, respectively. Infectious virus was isolated in culture from two samples among the 85 positive samples with Ct ≤37. On multi-variate analysis, only a positive result for SARS-CoV-2 RT-qPCR for patients' face masks was found to be significantly associated with surface contamination (odds ratio 5.79, 95% confidence interval 1.31-25.67; P=0.025).Conclusion: This study found that surface contamination by SARS-CoV-2 was more common than air and mask contamination. However, viable virus was rare. The inner surface of a patient's mask could be used as a marker to identify those at higher risk of contamination. [ABSTRACT FROM AUTHOR]

Summary: Although central Africa is classified as having a high endemicity of hepatitis B virus (HBV) and hepatitis D virus (HDV) infection, there is paucity of prevalence studies. For the first time on a country‐wide level in Central Africa, we show in Gabon an overall 7.4% prevalence of Hepatitis B surface antigen (HBsAg) and that more than 25% of the HBsAg‐positive population are infected by HDV. Although HBV prevalence did not differ significantly between provinces, there is a north‐south split in the distribution of HDV seroprevalence, with the highest rates (>66.0%) correlating with the presence of specific ethnic groups in the northeastern provinces. Genotyping revealed high genetic diversity of the HBV and HDV strains circulating in Gabon, including many restricted to this region of the globe. This work confirmed that high exposure to HBV and HDV infection reported in selected regions of Gabon holds true across the whole country. [ABSTRACT FROM AUTHOR]

Abstract: Background & Aims: Hepatitis D virus (HDV) infection is associated with a more severe outcome in patients with chronic hepatitis B (CHB); however, little is known about the presence of HDV in sub‐Saharan Africa. We aimed to determine the prevalence of HDV infection, as well as its clinical, biological and virological characteristics, in a large CHB cohort in Ethiopia. Methods: In total, 1267 HIV‐negative CHB patients at St. Paul's Hospital Millennium Medical College in Addis Ababa were screened for anti‐HDV antibodies using ELISA assays. Confirmed positive samples were further tested for HDV RNA using a consensus commercial real‐time RT‐PCR assay. HDV genotypes were also determined for RNA‐positive samples by nucleotide sequencing followed by phylogenetic analyses. Demographical, clinical and biological data from patients were recorded and compared based on HDV RNA results. Results: Most patients (n = 748, 59.0%) were men, and the median age was 31 years (interquartile range 26‐40). Anti‐HDV antibodies were detected in 19 individuals (1.5%), 12 of whom were HDV RNA‐positive with a viral load ranging from <2 to >8 log 10 IU/mL. All strains were genotype 1. HDV RNA‐positive patients were more likely to have significant liver fibrosis (63.6% vs 24.7%, P = .007) and cirrhosis (45.5% vs 16.4%, P = .024). Conclusions: HDV infection is rare in Ethiopia but is associated with more advanced liver fibrosis. [ABSTRACT FROM AUTHOR]