Background HIV status has commonly been found to affect the serum lipid profile. Objectives The aim of this study was to determine the effect of HIV infection on lipid metabolism; such information may be used to improve the management of HIV‐infected patients. Methods Samples were collected from December 2005 to May 2006 at Yaounde University Teaching Hospital, Yaounde, Cameroon. Lipid parameters were obtained using colorimetric enzyme assays, while low‐density lipoprotein cholesterol (LDLC) values were calculated using the formula of Friedewald et al. (1972) and atherogenicity index by total cholesterol (TC)/high‐density lipoprotein cholesterol (HDLC) and LDLC/HDLC ratios. Results HIV infection was most prevalent in subjects aged 31 to 49 years. Most of the HIV‐positive patients belonged to Centers for Disease Control and Prevention categories B (43.0%) and C (30.23%). Compared with control subjects, patients with CD4 counts<50 cells/μL had significantly lower TC (P<0.0001) and LDLC (P<0.0001) but significantly higher triglyceride (TG) values (P<0.001) and a higher atherogenicity index for TC/HDLC (P<0.01) and HDLC/LDLC (P=0.02); patients with CD4 counts of 50–199 cells/μL had significantly lower TC (P<0.001) and significantly higher TG values (P<0.001); patients with CD4 counts of 200–350 cells/μL had significantly higher TG (P=0.003) and a higher atherogenicity index for TC/HDLC (P<0.0002) and HDLC/LDLC (P=0.04); and those with CD4 counts >350 cells/μL had a higher atherogenicity index for TC/HDLC (P<0.0001) and HDLC/LDLC (P<0.001). HDLC was significantly lower in HIV‐positive patients irrespective of the CD4 cell count. Lipid parameters were also influenced by the presence of opportunistic infections (OIs). Conclusion HIV infection is associated with dyslipidaemia, and becomes increasingly debilitating as immunodeficiency progresses. HDLC was found to be lower than in controls in the early stages of HIV infection, while TG and the atherogenicity index increased and TC and LDLC decreased in the advanced stages of immunodeficiency.

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Context: The residual risk of HIV transmission is still a real problem into the transfusional settings of limited resources countries. Blood banks of African countries confront the risk of transmitting HIV to recipients. The objective of this study is to estimate the residual risk of HIV in African transfusion settings and to compare this residual risk with that of other countries in the South (developping countries). Methods: This study resulted of a systematic review with meta-analysis of data from several comprehensive studies carried out between 2011 and 2017 whose purpose was focused on the residual risk of HIV transmission through blood transfusion. The studies on the residual risk were systematically searched in the different databases (PubMed, Medline and Google Scholar). The eligibility criteria were based on published studies which had blood donors as participants, looking at the residual risk of HIV in developing countries and the technique was based on the search for antibodies-P24 Antigen of the HIV or on nucleic acid (RNA) testing. Studies carried out before 2011 and after 2017 were excluded. Studies in rich countries were also excluded. The Cochrane tool was used to assess the risk of bias. Results: A total of 327,278 seronegative donors (for 12 eligible studies) were admitted for this study, i.e. 75.5% of men and 24.5% of women. The median age of all donors was 30.4 years. For studies carried out in the Africa zone (Burkina Faso, Ivory Coast, Nigeria, Democratic Republic of Congo, Tanzania and Zimbabwe), 327,278 donors were initially seronegative, of which 626 were found to be positive. Indeed, out of 742 incident cases in this study from African countries and other countries of the South, 84.4% of positive donors came from African studies and 15.6% of positive donors came from other countries of the South in this study. The residual risk (RR) of HIV in Africa has been estimated at 13 per 1,000,000 donations, with an incidence rate (IR) of 21.5 per 100,000 person-years. And in the other countries of the South (Brazil, Croatia, India, Iran, Malaysia and Pakistan), the RR of HIV has been estimated at 0.6 per 1,000,000 donations, or an incidence rate of 1.1 per 100,000 person-years. Conclusion: The residual risk of HIV in the transfusion environment is still high and still persists in blood banks in southern countries in general and in Africa in particular.

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Background The high endemicity of transfusion-transmissible infections (TTIs) in sub-Saharan Africa is a real public health problem. To reduce the risk of HIV transmission through blood donation, the NBTC of Gabon has launched in recent years a reorganization of its blood transfusion system. This study aims to characterize the molecular strains of HIV-1 circulating in donors and to estimate the risk of viral transmission. Materials and methods A cross-sectional study was carried out during the period from August 2020 to August 2021 among 381 donors who had agreed to donate blood at the National Blood Transfusion Center (NBTC). Viral load was determined by Abbott Real-Time (Abbott m2000®, Abbott) and sequencing by the Sanger method (ABI 3500 Hitachi®). The phylogenetic tree was constructed by MEGA X software. Data were checked, entered, and analyzed using SPSS version 21.0 software, with p ≤ 0.05 considered statistically significant. Results A total of 381 donors were enrolled in the study. Among the 359 seronegative donors, five (5) seronegative donors were detected positive for HIV-1 using Real-Time PCR. The residual risk was 648 per 1,000,000 donations. The prevalence of residual infection was 1.4% [0,01; 0,03]. Sixteen (16) samples were sequenced. The strains obtained were CRF02_AG (50%), subtype A1 (18.8%), subtype G (12.5%), CRF45_cpx (12.5%) and subtype F2 (6.2%). Six sequences clustered with A1, G, CRF02_AG, and CRF45_cpx subtypes. Conclusion The residual risk of HIV-1 transmission by blood transfusion remains a concern in the Gabonese transfusional settings. A policy based on improving the current screening strategy would involve the implementation of the nucleic acid test (NAT) in order to optimize the safety of the donation by detecting the HIV-1 subtypes in circulation in the donors.

Background: Blood transfusions carry the risk of transmitting blood-borne infections. A precise estimate of the transfusion risk of viral infection will help to determine the effect of new and current safety measures in sub-Saharan Africa. This study proposes to estimate the residual risk of HBV in blood banks in African countries and to compare them to other countries in the South. Methods: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, Medline, Google Scholar and Zotero were accessed. The eligibility criteria were based on published studies that had blood donors as participants, looking at the residual risk of HBV in developing countries and the technique was based on the search for HBsAg or Hepatitis B Core Antibodies or Nucleic Acid (DNA) testing. The Cochrane tool was used to assess the risk of bias. Results: Twelve articles comprising 71,207 allogeneic and hepatitis B surface antigen (HBsAg)-negative blood donations were included in the meta-analysis. A total of 4912 HBsAg negative African donation including (51.0%) new donors and (49.0%) from regular donors. 80.8% of them were male and the median age was 28 years. Of 1225 HBV strains (47% and 53.4% incident cases) were frequencies in sub-Saharan Africa and in other Southern countries respectively. Considering the twelve participating blood centres as a whole, the incidence rate of new infections was high (4905.1) in sub-Saharan Africa than (869.7) in other Southern countries per 100,000 person-years. In contrast, the estimated residual risk in sub-Saharan Africa (5913 in 1 million donations) was five times higher than estimated in other Southern countries (1048.4 in 1 million donations). Conclusion: Blood donations with HBsAg undetectable by routine testing and low levels of HBV DNA are extremely common in sub-Saharan Africa, at a rate of 5913 per 1 million donations. Given that at least several of these samples could reflect contamination or a false negative result, elimination of infection by a test limited to HBsAg does not prevent transmission.

Background Ivermectin (IVM) is a broad spectrum endectocide whose initial indication was onchocerciasis. IVM-based preventive chemotherapies (PC), so-called Community-Directed Treatment with Ivermectin (CDTI), have led to the interruption of transmission of onchocerciasis in some foci. Although loiasis is not among its indications, IVM also exhibits antiparasitic activity against Loa loa. Because of the geographic overlap of onchocerciasis and loiasis in Central Africa, one would have expected similar trend for loiasis in co-endemic settings. Surprisingly, a recent study revealed that L. loa entomological indices remained almost unchanged after 13 years of CDTI to fight onchocerciasis. This study then aimed to assess whether parasitological indicators of L. loa infection follow the same trends than the previously described entomological indices. A cross-sectional study was conducted in six communities of the Yabassi Health District where CDTI have been implemented since ~ 20 years to fight onchocerciasis. All volunteers aged ≥ 5 years underwent daytime calibrated thick blood smears to search for L. loa microfilariae (mf), then prevalence and intensity of infection were compared to baseline data. Results A total of 376 individuals (55.9% female), aged 5 to 89 years old, were enrolled in this study. The prevalence of loiasis was 3.7% (95% CI: 2.2–6.2), significantly lower than its baseline (12.4%; 95% CI: 10.1–15.2) (Chi-Square = 21.4; df = 1; p < 0.0001). Similarly, the microfilarial density was significantly low (Mean = 1.8 mf/mL; SD = 13.6; max = 73,600) compared to baseline (Mean = 839.3 mf/mL; SD = 6447.1; max = 130,840) (Wilcoxon W = 179904.5; p < 0.0001). Conclusions This study revealed that the prevalence and intensity of L. loa infection were significantly low compared to their baselines, indicating a significant impact of IVM-based PC on this filarial disease. However, transmission is still ongoing, and heavily infected individuals are still found in communities, supporting why some individuals are still experiencing severe adverse events despite > 2 decades of CDTI in this Health District.

Background: Transmission of HIV through blood transfusion remains a public health problem, particularly in countries in Sub-Saharan Africa. However, no study has determined the epidemiological data regarding HIV-1 infection in Gabonese blood donors. The objective of this study is to assess the seroprevalence of HIV-1 and the risk factors associated with infection in donors from the National Blood Transfusion Center in Libreville (Gabon). Methods: A cross-sectional study carried out from June to August 2020 in 3669 persons donating blood at the National Blood Transfusion Center (NBTC). The ELISA technique (Evolis®, BioRad), the chemiluminescence technique (Cobas® e601, Roche), and the SD Bioline® HIV 1/2 test (Standard Diagnostics. Inc) were used for the detection of anti-HIV-1/2 antibodies and P24 antigen in donor plasma. Data were analyzed using SPSS software version 21.0, with p˂.05 considered statistically significant.  Results: The seropositivity rate HIV-1 was 0.8% (30/3669) (95% CI: 0.5; 1.1). The study was composed of 79.4% men and 20.6% women. The most representative age group was of 25-34 years with 54.5%. The seropositivity of men, women, and unrelated voluntary donors was 0.7%, 1.2%, and 1.0%, respectively. The risk factors such as the first blood donation (Adjusted Odds Ratio (AOR) = 0.1 [0.0 ;0.4], P= .002), multiple sexual partners (AOR = 6.2 [2.2;17.2], P= .001), primary educational level (AOR = 10.1 [1.4;75], P = .024), and dental care (AOR = 3.6 [1.2;11], P = .024) were significantly associated with HIV infection. About 0.14% of the patients had co-infection. Conclusion: In the Gabonese context, about one out of a hundred blood donors are HIV-infected. These carriers of HIV infection in the blood banks are mainly new donors with multiple sexual partners, limited education, and poor dental care.