Kaposi’s sarcoma (KS) is a tumor that primarily affects the skin, caused by a multifactorial pathogenesis mediated through immune dysfunction, often leading to increased morbidity and mortality in Sub-Saharan Africa (SSA). Human herpesvirus-8, also known as Kaposi’s sarcoma-associated herpesvirus (KSHV), induces an infection that can facilitate the pathogenesis of KS and other conditions. All KSHV subtypes depend on the expression of specific markers, such as K1 proteins, which play critical roles in their life cycles. The infection is unevenly scattered worldwide, with individuals infected with human immunodeficiency virus (HIV) and pregnant women being among the most vulnerable groups. HIV infection and related effectors, such as TAT proteins, have substantial impacts on KSHV infectiousness, angiogenesis, various signaling pathways, and KS pathogenesis. Africa endures the heaviest burden of KS, which affects both men and women, sometimes from an early age. KS’s pathogenesis and underlying mechanisms remain unclear; this study aims to highlight the dynamics to be considered in managing and mitigating the burden of KS in SSA. In that region, certain infections are endemic and can cause intermediate health damage leading to KS tumorigenesis, highlighting the link between non-communicable and communicable diseases.

Background/Objectives. Women living with human immunodeficiency virus (WLWH) have a six-fold higher risk of developing cervical cancer associated with high-risk human Papillomavirus (HR-HPV) than HIV-negative women. We herein assessed HR-HPV genotype distribution and plasma levels of the cancer antigen 125 (CA-125) in WLWH in a rural town in Gabon, in Central Africa. Methods. Adult WLWH attending the local HIV outpatient center were prospectively enrolled and underwent cervical visual inspection and cervicovaginal and blood sampling. HIV RNA load and CA-125 levels were measured from plasma using the Cepheid^® Xpert^® HIV-1 Viral Load kit and BioMérieux VIDAS^® CA-125 II assay, respectively. HPV detection and genotyping were performed via a nested polymerase chain reaction (MY09/11 and GP5+/6+), followed by sequencing. Results. Fifty-eight WLWH (median age: 52 years) were enrolled. Median CD4 count was 547 cells/µL (IQR: 412.5–737.5) and HIV RNA load 4.88 Log₁₀ copies/mL (IQR: 3.79–5.49). HPV prevalence was 68.96%, with HR-HPV detected in 41.37% of women. Among HR-HPV-positive samples, 87.5% (21/24) were genotypes targeted by the Gardasil vaccine, while 12.5% (3/24) were non-vaccine types. Predominant HR-HPV types included HPV-16 (13.8%), HPV-33 (10.34%), HPV-35 (5.17%), HPV-31, and HPV-58 (3.45%). Most participants had normal cervical cytology (62.07%), and a minority (14.29%) had elevated CA-125 levels, with no correlation to cytological abnormalities. Conclusions. In the hinterland of Gabon, WLWH are facing an unsuspected yet substantial burden of cervical HR-HPV infection and a neglected risk for cervical cancer. Strengthening cervical cancer prevention through targeted HPV vaccination, sexual education, and accessible screening strategies will help in mitigating associated risk.

Astroviruses (AstVs), enteroviruses (EVs), and caliciviruses (CaVs) infect several vertebrate taxa. Transmitted through the fecal–oral route, these enteric viruses are highly resistant and can survive in the environment, thereby increasing their zoonotic potential. Here, we screened for AstVs, EVs, and CaVs to investigate the role of domestic animals in the emergence of zoonoses, because they are situated at the human/wildlife interface, particularly in rural forested areas in Central Africa. Rectal swabs were obtained from 123 goats, 41 sheep, and 76 dogs in 10 villages located in northeastern Gabon. Extracted RNA reverse-transcribed into cDNA was used to detect AstVs, EVs, and CaVs by amplification of the RNA-dependent RNA polymerase (RdRp), or capsid protein (VP1) gene using PCR. A total of 23 samples tested positive, including 17 goats for AstVs, 2 goats, 2 sheep, 1 dog for EVs, and 1 dog for CaVs. Phylogenetic analyses revealed that AstV RdRp sequences clustered with sheep-, goat-, or bovine-related AstVs. In addition, one goat and two sheep VP1 sequences clustered with caprine/ovine-related Evs within the Enterovirus G species, and the CaV was a canine vesivirus. However, human-pathogenic Evs, EV-B80 and EV-C99, were detected in goats and dogs, raising questions on the maintenance of viruses able to infect humans.

The Joint United Nations Program on HIV/AIDS (UNAIDS) has adopted the Sustainable Development Goals (SDGs) to end the HIV/AIDS epidemic by 2030. Several factors related to the non-suppression of HIV, including interruptions of antiretroviral therapy (ART) and opportunistic infections could affect and delay this projected epidemic goal. Human T-Cell leukemia virus type 1 (HTLV-1) appears to be consistently associated with a high risk of opportunistic infections, an early onset of HTLV-1 and its associated pathologies, as well as a fast progression to the AIDS phase in co-infected individuals, when compared to HIV-1 or HTLV-1 mono-infected individuals. In Gabon, the prevalence of these two retroviruses is very high and little is known about HTLV-1 and the associated pathologies, leaving most of them underdiagnosed. Hence, HTLV-1/HIV-1 co-infections could simultaneously imply a non-diagnosis of HIV-1 positive individuals having developed pathologies associated with HTLV-1, but also a high mortality rate among the co-infected individuals. All of these constitute potential obstacles to pursue targeted objectives. A systematic review was conducted to assess the negative impacts of HTLV-1/HIV-1 co-infections and related factors on the elimination of HIV/AIDS by 2030 in Gabon.

Background: The fight against HIV in the Democratic Republic of Congo (DRC) is hindered by systemic challenges; notably, limited access to HIV viral load (VL) testing. Achieving VL suppression is the primary global target for eliminating HIV as a public health threat by 2030. This study aimed to determine the rate of VL suppression and identify associated factors among people living with HIV (PLHIV) receiving antiretroviral therapy (ART) in Bunia. Methods: A descriptive and analytical cross-sectional study was conducted among PLHIV receiving care at treatment sites in Bunia over a period of 11 months. Participants were selected using a two-stage sampling approach, consisting of non-random quota sampling followed by simple random sampling. The primary endpoint was the proportion of PLHIV achieving VL suppression, while associated factors were identified using multiple logistic regression analysis. Results: Overall, 603 PLHIV were enrolled, including 180 males (29.9%) and 423 females (70.1%). The median age was 40 years (IQR: 32–48), median duration on ART was 38 months (IQR: 15–91), and VL suppression was achieved by 75% of the participants. While this indicates significant progress, it remains below the UNAIDS 95-95-95 targets. Adherence to antiretroviral therapy (aOR = 139.43; 95% CI: 66.63–291.76; p < 0.001) and being female (aOR = 2.15; 95% CI: 1.02–4.53; p = 0.044) emerged as independent predictors of virological success. Conclusions: Enhancing access to VL testing and optimizing ART adherence support strategies are critical to improving VL suppression rates in Bunia. Addressing these gaps is essential for the DRC to align with the global health objectives.

Significant advancements in, and increased access to, antiretroviral therapy (ART) have substantially reduced the risk of mother-to-child transmission (MTCT) of HIV. However, antiretroviral drug resistance (HIVDR) is a serious challenge affecting both adults and children. Because of high HIV prevalence and genetic diversity, Central Africa is considered the epicenter of the epidemic. Yet information on drug resistance profiles and clinical efficacy of newer antiretroviral agents among children is limited compared to adult cohorts. Not to mention that several countries of the subregion, including Gabon, Chad, and São Tomé and Príncipe, lack updated epidemiological data. This article aims to provide an overview of HIV prevention of mother-to-child transmission (PMTCT), focusing on four key elements: prevalence rates; associated risk factors; molecular characterization of pediatric HIV; and virological response to antiretroviral therapy in Central Africa. We have gathered studies published between 2014 and 2026 across PubMed and Research Gate databases and AJOL. The synthesized data reveal high genetic variability of HIV and a dominant CRF02AG variant within the considered populations. The results of this study indicate a range of virological failure rates in the pediatric population on ART for at least six months, ranging from 11.1% to 89.1%. These rates are attributed to a high frequency of resistance-associated mutations (RAMs) and suboptimal adherence to antiretroviral treatment. The main determinants of non-adherence are social stigma, geographic barriers (distance from specialized care centers) and orphan status. Strengthened virological and molecular surveillance programs must be implemented in Central Africa to ensure optimal care for pregnant women, children, and adolescents. Addressing these gaps is imperative in order to bridge the gap between the current epidemiological profile and the WHO’s goals for the elimination of pediatric HIV.