Molecular Characterization of Mycobacterium Tuberculosis in HIV Patients Receiving Antiretroviral Drugs in Cameroon

Gerades Dely Djoufack; Lem Edith Abongwa; Allan Olayemi Campbell; Julian Sydney Olufemi Campbell; Kabir Gorden; Jean M Mendimi Nkodo; Christian Happi; Onikepe Folarin

doi:10.4103/ijmy.ijmy_47_25

Molecular Characterization of Mycobacterium Tuberculosis in HIV Patients Receiving Antiretroviral Drugs in Cameroon

Int J Mycobacteriol. 2025 Apr 1;14(2):182-190. doi: 10.4103/ijmy.ijmy_47_25. Epub 2025 Jun 20.

Authors

Gerades Dely Djoufack^{1

2}, Lem Edith Abongwa^{1

2

3}, Allan Olayemi Campbell^{1

2}, Julian Sydney Olufemi Campbell^{1

2}, Kabir Gorden^{1

2}, Jean M Mendimi Nkodo⁴, Christian Happi^{1

2}, Onikepe Folarin^{1

2}

Affiliations

¹ Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, Ede, Osun State, Nigeria.
² Institute of Genomics and Global Health, Redeemer's University, Ede, Osun State, Nigeria.
³ Department of Microbiology and Parasitology, Faculty of Science, University of Bamenda, Bamenda, Cameroon.
⁴ Jamot Hospital Yaoundé, Yaoundé, Cameroon.

PMID: 40540663
DOI: 10.4103/ijmy.ijmy_47_25

Abstract

Background: Tuberculosis (TB) remains a leading cause of mortality among people living with HIV/AIDS, who face a tenfold higher risk of Mycobacterium tuberculosis (MTB) infection. TB-HIV coinfection complicates disease management due to drug interactions, overlapping toxicities, immune reconstitution inflammatory syndrome, and high treatment burdens, potentially driving drug resistance. The emergence of resistant MTB further exacerbates this challenge. This study evaluated the drug resistance profile of MTB in TB-confirmed samples from HIV-positive patients.

Methods: An analytical cross-sectional study was conducted on 216 sputum samples from HIV patients on antiretroviral therapy at Jamot Hospital, Yaoundé, Cameroon (June-September 2022). Two consecutive samples per patient underwent fluorescent microscopy (Auramine-Rhodamine stain) and TB-Loop-Mediated Isothermal Amplification. DNA was extracted using the GenoLyse® kit (Hain Lifescience, Germany), and drug resistance profiles were assessed via GenoType® MTBDRplus and MTBDRsl line probe assays.

Results: TB was confirmed in 12.04% (26/216) of participants. Rifampicin (RIF) and isoniazid (INH) resistance were each detected in 50% (13/26) of cases, with 23% (6/26) exhibiting multidrug-resistance (MDR). Predominant mutations included rpoB MUT2B (15.38%) for RIF and inhA MUT2A (23.06%) for INH. Second-line resistance analysis revealed 61.54% (8/13) resistance to kanamycin (KAN)/amikacin (AMK)/viomycin, 7.69% (1/13) to AMK/capreomycin/viomycin, and 7.69% (1/13) to KAN. Notably, 61.54% (8/13) lacked the rrs wild-type probe, indicating resistance to injectable TB drugs.

Conclusion: High MDR-TB prevalence was observed among HIV-TB coinfected patients, underscoring the urgent need for enhanced resistance surveillance and optimized treatment strategies in TB/HIV-endemic regions like Cameroon. Further research is warranted to elucidate HIV's role in driving TB drug resistance.

Keywords: Coinfection; molecular characterization; tuberculosis.

MeSH terms

Adult
Anti-Retroviral Agents* / therapeutic use
Antitubercular Agents* / pharmacology
Antitubercular Agents* / therapeutic use
Cameroon / epidemiology
Coinfection / microbiology
Cross-Sectional Studies
Female
HIV Infections* / complications
HIV Infections* / drug therapy
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Mycobacterium tuberculosis* / drug effects
Mycobacterium tuberculosis* / genetics
Mycobacterium tuberculosis* / isolation & purification
Sputum / microbiology
Tuberculosis
Tuberculosis, Multidrug-Resistant* / epidemiology
Tuberculosis, Multidrug-Resistant* / microbiology
Young Adult

Substances

Antitubercular Agents
Anti-Retroviral Agents