Published November 19, 2025
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Updates on the Clinical Epidemiology of HIV-1 Group O Strains in Cameroon and Potential Implications on Diagnosis and Treatment Strategies.

Creators

  • 1. Chantal Biya International Reference Centre for HIV/AIDS Prevention and Management, Yaoundé, Cameroon; Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon; Faculty of Health Sciences, University of Buea, Buea, Cameroon; National HIV Drug Resistance Working Group, Yaoundé, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. Electronic address: josephfokam@gmail.com.
  • 2. Chantal Biya International Reference Centre for HIV/AIDS Prevention and Management, Yaoundé, Cameroon; National HIV Drug Resistance Working Group, Yaoundé, Cameroon; Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
  • 3. University of Rome Tor Vergata
  • 4. Chantal Biya International Reference Centre for HIV/AIDS Prevention and Management, Yaoundé, Cameroon; National HIV Drug Resistance Working Group, Yaoundé, Cameroon.
  • 5. Chantal Biya International Reference Centre for HIV/AIDS Prevention and Management, Yaoundé, Cameroon; Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
  • 6. Chantal Biya International Reference Centre for HIV/AIDS Prevention and Management, Yaoundé, Cameroon.
  • 7. Chantal Biya International Reference Centre for HIV/AIDS Prevention and Management, Yaoundé, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
  • 8. Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
  • 9. Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; Department of Heritage and Financial Resources, Ministry of Public Health, Yaoundé, Cameroon; Department of Disease, Epidemics and Pandemic Control, Ministry of Public Health, Yaoundé, Cameroon.
  • 10. Department of Disease, Epidemics and Pandemic Control, Ministry of Public Health, Yaoundé, Cameroon.
  • 11. Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; Department of Disease, Epidemics and Pandemic Control, Ministry of Public Health, Yaoundé, Cameroon.
  • 12. Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon; Management Sciences for Health, Yaoundé, Cameroon.
  • 13. Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon.
  • 14. Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon; Department of Disease, Epidemics and Pandemic Control, Ministry of Public Health, Yaoundé, Cameroon.
  • 15. National Public Health Laboratory, Ministry of Public Health, Yaoundé, Cameroon.
  • 16. Faculty of Health Sciences, University of Buea, Buea, Cameroon.
  • 17. Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; Division of Health Operational Research, Ministry of Public Health, Yaoundé, Cameroon.
  • 18. Chantal Biya International Reference Centre for HIV/AIDS Prevention and Management, Yaoundé, Cameroon; UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy.
  • 19. Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
  • 20. Chantal Biya International Reference Centre for HIV/AIDS Prevention and Management, Yaoundé, Cameroon; Institute of Biological Systems, National Research Council, Rome, Italy; Laboratory for Major Tropical Epidemics, University Hospital Complex, N'Djamena, Chad.
  • 21. Consiglio Nazionale delle Ricerche
  • 22. National HIV Drug Resistance Working Group, Yaoundé, Cameroon; Faculty of Medicine and Pharmaceutical Sciences of the University of Dschang, HIV Treatment Centre of the Yaoundé Central Hospital, Centre for Research on Emerging and Re-emerging Diseases, Yaoundé, Cameroon.
  • 23. World Health Organization, Country Office, Yaoundé, Cameroon.
  • 24. Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
  • 25. Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia; Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland.
  • 26. Chantal Biya International Reference Centre for HIV/AIDS Prevention and Management, Yaoundé, Cameroon; EUROBIOPARK and UNESCO Board of Biotechnology, University of Rome Tor Vergata, Rome, Italy; Faculty of Medicine, CHU Bon-Samaritain, N'Djamena, Chad.
  • 27. Chantal Biya International Reference Centre for HIV/AIDS Prevention and Management, Yaoundé, Cameroon; Bambino Gesù Pediatric Hospital, IRCCS, Rome, Italy.
  • 28. Scientific Institute for Research, Hospitalization and Healthcare
  • 29. Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon; Global Funds and Partners Subvention Coordination Unit, Ministry of Public Health, Yaoundé, Cameroon.
  • 30. Ministry of Public Health, Yaoundé, Cameroon.

Description

Cameroon is an epicenter of diverse HIV-1 strains, with diagnostic and management challenges. The objective herein was to update HIV-1 non-M prevalence and compare diagnostic performance of two- versus three-test algorithms. A facility-based study was conducted in February 2024 on 2207 HIV-1 clinical samples at the Chantal Biya International Reference Centre (Yaoundé, Cameroon). HIV-1 non-M were identified by molecular phylogeny. Rapid diagnostic tests (RDTs) used in the two-test (Determine and KHB colloidal gold) versus three-test (First Response, One Step, and KHB) algorithms were evaluated on non-M, with ACRO (HIV1/2 and p24) as independent RDT. No group N (0%) nor P (0%) was found, whereas nine group O were identified (0.4%; 95% CI, 0.2%-0.8%). For individuals harboring group O (mean age, 43 ± 12 years; 50% female), median (IQR): duration since HIV diagnosis was 627 (423 to 775) weeks; viremia, 12,385 (5340 to 72,682) copies/mL; and CD4 count, 52 (39 to 228) cells/mm3. One Step, KHB, and ACRO detected eight of eight group O (100%); First Response HIV1-2.0, seven of eight (87.5%); and Determine HIV1/2, six of eight (75%), P = 1.00. In this Cameroonian setting, HIV-1 group N and P are scarce, whereas group O remains low (<1%). Transitioning from the two-test (75% performance) to the three-test algorithm (87.5% performance) could lead to improved diagnostic performance on currently circulating HIV-1 group O, calling for updates in RDTs to adapt to viral dynamics.
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