The rates of virological failure (VF) and HIV-1 drug resistance were evaluated in a cross-sectional study in HIV-1-infected children living in Dakar, and taking antiretroviral treatment (ART) according to WHO recommendations. The plasma HIV-1 RNA load was measured using the Abbott m2000 RealTime HIV-1 assay. The full-length protease gene and partial reverse transcriptase gene were sequenced, and resistance mutations were assessed by reference to the Stanford University HIV drug resistance database. Of 125 included children (median age, 7 years) taking first-line ART for a median duration of 20 months, 82 (66%) showed detectable HIV-1 RNA load, and 70 (56%) met the 2010 revised WHO criteria of VF (defined as plasma HIV-1 RNA load ≥3.7 log(10) copies/ml). Drug resistance results were available for 52 children with plasma HIV-1 RNA load ≥3.0 log(10) copies/ml, and viruses carrying resistance mutations were found in 48 (92%) children. Among these 48, mutations conferring resistance to nucleoside reverse transcriptase inhibitors (NRTIs) or non-NRTIs (NNRTIs) were found in 42 (88%) and 47 (99%) children, respectively. The NRTI-resistant viruses harbored the M184V/I (95%), Q151M (2%), and thymidine-analogue mutations (40%), and the NNRTI-resistant viruses harbored the K103N (34%), Y181C (32%), G190A (23%), and K101E (21%) mutations. A high rate (56%) of VF was demonstrated in Senegalese children after 20 months of first-line ART and therapeutic failure was assessed by the presence of antiretroviral drug resistance mutations in 9 out of 10 children in VF. These findings point out the difficulties of optimizing ART in children living in sub-Saharan Africa, and the crucial need of laboratory monitoring reinforcement.

f Among 464 sera from adults in Cameroon, 56 (12.1%) gave inconclusive HIV serology. All were negative for HIV-1 DNA; 44.6% (n ‫؍‬ 25) were significantly associated with Plasmodium (42.8%) or Epstein-Barr virus (EBV) (17.8%) infections. In Central Africa, sera giving inconclusive results for HIV are frequently associated with malaria, EBV infection, or both.S erum tested for HIV should respond consistently and identically whatever the serological test used and should be either negative or positive. A serum sample can be classified as "inconclusive" when it yields a questionable or indeterminate result for a serological HIV test or when it gives discrepant results in different HIV tests used when a given algorithm for assessing serum for HIV infection serodiagnosis is followed.Despite the increase in the quality of serodiagnostic HIV tests, it has become apparent that the serology of HIV infection remains particularly difficult in Central Africa. Thus, the frequency of inconclusive sera varies depending on definitions, ranging from 3.4% in the Central African Republic (1), to 8.4% (2) and 9% (3) in Cameroon, and even to 10.5% in the Democratic Republic of Congo (4). Reported causes of indeterminate or discrepant rapid HIV test results include early HIV infection (5, 6) and false-positive reactions due to a variety of conditions associated with autoimmunity (7), pregnancy (8), and vaccinations against influenza (9), hepatitis B (10), and rabies (11), as well as concurrent infection by other pathogens. Several associations have been found between indeterminate HIV serologies and a number of infectious diseases, such as uncomplicated malaria (11, 12), sleeping sickness due to Trypanosoma brucei gambiense (13), schistosomiasis (14), leishmaniasis (15), syphilis (16), and dengue (11).(Preliminary results of the study were presented at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy, 10 to 13 September 2013, Denver, CO [17].)A total of 464 volunteers were prospectively included during HIV screening campaigns by mobile units in northwestern Cameroon. For each volunteer, informed consent was obtained; a blood sample was collected in dry tubes, and two aliquots of decanted serum were conserved. One aliquot was used for immediate HIV screening testing in the mobile unit, as described previously (18). The second was sent to the Laboratoire National de Santé Hygiène Mobile and frozen at Ϫ20°C. In addition, dried blood spot (DBS) samples were prepared using Whatman 903 filter paper (Schleicher & Schuell, Whatman, Versailles, France) and stored at Ϫ30°C, as described previously (19). The study protocol was approved by the Cameroonese Ethical Committee.The combination of the test results obtained in parallel by Alere Determine Test HIV-1/2 Ag/Ab Combo (Alere Inc., Waltham, MA) and ImmunoComb II HIV 1 & 2 CombFirm (Alere Inc.) gave a high frequency of inconclusive results for the 464 collected sera, including 382 (82.3%) negative, 26 (5.6%) positive, and 56 (12.1%) inconclusive sera.The DBS samples from...

Aim: The seed beetle Callosobruchus maculatus is an important tropical and subtropical pest of legumes distributed world-wide. Archaeological evidence suggests an African origin with later world-wide invasion facilitated by the last centuries' legume trading and exchange. To date, no studies could identify the routes or timing of dispersal of the species. Here, we investigate the global phylogeography of this pest to shed light on the main inter-continental dispersal routes that led to it becoming a cosmopolitan pest.Location: World-wide.Methods: We sampled seed beetles over a large fraction of the species' range and sequenced one nuclear and three mitochondrial loci. Using this data, we estimated spatio-temporal phylogeographical reconstructions, and the demographic history of the species. We also used our dataset to evaluate the effect of panmixia on Bayesian demographic estimations.Results: Callosobruchus maculatus exhibited regional and continental genetic structure, with the highest genetic diversity found in Africa. Our discrete Bayesian phylogeographical approach indicated that the species first dispersed to Asia and then colonized the pantropical belt. The three methods used for inferring the demographic history of C. maculatus indicated a recent demographic expansion in the world-wide dataset, as well as in the subset restricted to African samples. Such a signal was, however, not observed in the subset composed of Asian specimens. This demographic expansion occurred in the Holocene and is likely explained by the spread of cowpea and other host legumes across and out of Africa. Main conclusions:The inferred dispersal routes support the idea that the evolutionary history of C. maculatus relates to the trade of its main host plant, Vigna unguiculata. Human-mediated processes appear to have shaped the global genetic structure of this pest. As a methodological implication, we demonstrate that coalescent-based demographic reconstructions can be erroneous if the dataset violates the assumption of panmixia. K E Y W O R D SBruchinae, Callosobruchus, demographic history, dispersal routes, human-mediated dispersal, insect pest, world-wide distribution

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