MARVEL-minimising the emergence and dissemination of HIV-1 drug resistance in Portuguese-speaking African Countries (PALOP): low-cost portable NGS platform for HIV-1 surveillance in Africa
BMC infect. dis; 24 (1), 2024
Ano de publicação: 2024
Background HIV-1 infections remain a global public health concern. Scaled-up antiretroviral treatment (ART) is
crucial for reducing morbidity and mortality related to HIV/AIDS. The emergence of drug-resistance mutations
(DRMs) compromises viral suppression and contributes to the continued HIV-1 transmission. Several reports indicate
a recent increase in acquired (ADR) and transmitted (TDR) drug resistance in Africa, probably linked to the lack of
implementation of HIV drug resistance (HIVDR) testing and suboptimal treatment adherence. Herein, we will develop
a low-cost protocol using third-generation sequencing (Oxford Nanopore Technology) for HIV-1 surveillance in
Portuguese-speaking African Countries - PALOP [Angola (AO), Cape Verde (CV), Mozambique (MZ), and Sao Tome &
Principe (STP)].
Methods This is a multicentric cross-sectional study that includes around 600 adult patients newly diagnosed with
HIV-1 in the PALOP. An epidemiological questionnaire previously validated by our research team will be used to collect
sociodemographic and clinical data. Also, whole blood samples will be collected and the plasma samples will be
subjected to drug resistance testing using an in-house low-cost NGS protocol. Data analysis will involve bioinformatics,
biostatistics and machine learning techniques to generate accurate and up-to-date information about HIV-1 genetic
diversity, ADR and TDR.