5 Monivong Boulevard, P.O Box. 983, Phnom Penh, Cambodia accueil@pasteur-kh.org

Research projects developed by the HIV/Hepatitis Unit are mainly focused on hepatitis B, C and E and on HIV. By the end of May 2014, they were as follows:

PROJECTS ON VIRAL HEPATITIS

Hepatitis B

HBV, Project 1: Prevention of mother-to-child transmission (PMTCT) of hepatitis B virus (HBV) in context of late access to care in Cambodia: Implementation of groups, collaborations and tools needed for the implementation of a research protocol.
Submission to: Agence Nationale de Recherches sur le SIDA et les hépatites virales (ANRS), March 2014.
Collaborations:
FRANCE:
– Drs Olivier SEGERAL and Cécile GOUJARD, Infectious Diseases Unit, Kremlin-Bicêtre Hospital, Kremlin-Bicêtre.
– Pr Anne-Marie ROQUE, Virology laboratory, Hepato-Biliary Center, Paul Brousse Hospital, Villejuif.
CAMBODIA:
– Dr Meng Ly EK, Maternity, Calmette Hospital, Phnom Penh.
– Dr Channa SANN, Hepato-gastro-enterology, Calmette Hospital, Phnom Penh.
– Drs Hubert BARENNES, Laurence BORAND, Arnaud TARANTOLA, Epidemiology and Public Health Unit, Pasteur Institute in Cambodia, Phnom Penh.
– Dr Alexandra KERLEGUER, Clinical Biology Laboratory, Pasteur Institute in Cambodia, Phnom Penh.
– Dr Kimcheng HOK, National Blood Transfusion Center, Phnom Penh.
Main goals:
– To evaluate the analytical performance (sensitivity, specificity) of rapid tests for the detection of HBsAg and HBe Ag.

HBV, Project 2: Validation of an automated, low-cost real-time PCR test for diagnosing and monitoring of hepatitis B infection in African and Asian resource-limited settings.
Submission to: Agence Nationale de Recherches sur le SIDA et les hépatites virales (ANRS), March 2014.
Collaborations:
FRANCE:
– Dr Edouard TUAILLON, INSERM U 1058, Montpellier.
– Pr Jean-Christophe PLANTIER, Virology laboratory, CHU of Rouen, Rouen.
– Pr Christine ROUZIOUX, Virology laboratory, CHU Necker-Enfants Malades, Paris.
CAMBODIA:
– Dr Alexandra KERLEGUER, Clinical laboratory, Pasteur Institute in Cambodia, Phnom Penh, Cambodia.
OTHER ASIAN COUNTRIES:
– Dr Nicole NGO-GIANG-HUONG, IRD UMI 174, Chiang Mai, Thailand
– Dr Duy Hoang Chuong LE, Institut Pasteur in Vietnam, Ho Chi Minh Ville, Vietnam
AFRICAN COUNTRIES
– Dr Dramane KANIA, Centre Muraz, Bobo-Dioulasso, Burkina Faso.
– Dr Richard NJOUOM, Institut Pasteur in Cameroun, Yaoundé, Cameroon.
– Dr Thomas d’Aquin TONI, CeDReS, Abidjan, Ivory Coast.
– Dr Almoustapha Issiaka MAIGA, SEREFO, Bamako, Mali.
– Pr Ndèye Coumba TOURE-KANE, Virology laboratory, CHU Le Dantec, Dakar, Senegal.
– Pr Anoumou DAGNRA, BIOLIM, Lome, Togo.
Main goals:
– To validate a generic quantitative HBV DNA PCR technique using automated open platforms of molecular biology.

Hepatitis C

HCV, Project 1: The many faces of Hepatitis C virus (HCV): Impact of defective genomes on pathogenesis of liver disease by assessment of exosomes secretion (acronym: HEPA-DEFEXO).
Submission to: « Actions Concertées Inter Pasteuriennes » (ACIP) 2014 of the Institut Pasteur International Network (March 2014).
Collaborations:
– Dr Urania GEORGOPOULOU, Hellenic Pasteur Institute (HPI), Athena, Greece.
– Dr Soumaya BENJELLOUN, Pasteur Institute in Morocco, Casablanca, Morocco.
– Dr Pascal PINEAU, Pasteur Institute in Paris, Paris, France.
Main goals:
– To search for HCV natural mutants, containing large in-frame deletions (IFDM) affecting the envelope region, in plasma/serum and tissue biopsies of HCV-infected individuals. Through this objective we will investigate the prevalence of in-frame deletions in E1E2 coding region from HCV positive sera of genotype 6 and from tissue biopsies belonging to tumor (hepatocellular carcinoma, HCC) and matching non-tumor liver (NTL) from HCV-infected patients.
– To characterize exosomes isolated from serum/plasma of HCV-infected individuals at different disease stages in the presence or absence of IFDMs.

Hepatitis E

HEV, Project 1: Hepatitis E virus (HEV) infection among specific groups from Cambodia: individuals with unexplained ALT elevation, immunocompromised HIV-1-infected adult patients, blood donors and HIV-1-infected men having sex with men.
Administrative information: Submission to the Call Pasteur-Fiocruz 2013-2015 / Project approval in December 2013 / Approval by the Cambodian Ethics Committee in February 2014.
Partners:
– Dr Marcelo PINTO ALVES, Fiocruz, Rio de Janeiro, Brazil.
– Dr Richard NJOUOM, Pasteur Center in Cameroon, Yaounde, Cameroun.
Main goals:
This study is part of multi-centre study conducted also in Brazil (South America) and Cameroon (Central Africa). The main objectives are:
– To determine the seroprevalence of HEV antibodies (IgG and IgM) among specific groups of Cambodian subjects: individuals with unexplained ALT elevation, immuno-suppressed HIV-1-infected adult patients, blood donors, and HIV-1 infected men having sex with men (MSM) under HAART.
– To assess HEV RNA viremia among patients presenting positive HEV serology.

HIV projects

HIV, Project 1: National evaluation of PI-based 2nd line efficacy in Cambodia (ANRS 12276 2PICAM project).
The project ANRS 12276 is coordinated by NCHADS. HIV/Hepatitis Unit at IPC is supporting technology transfer of drug resistance test.

Financial support:
ANRS 12276
Partners:
Vonthanak Saphonn (NCHADS, Phnom Penh, Cambodia), Eric Nerrienet (Regulation of Retroviral Infection Unit, Institut Pasteur Paris), Bruno Spire (Observatoire régional de la santé – UMR912 SE4S, Marseille, France)
Main goals:
Around 2,000 patients already switched to 2nd line, on the basis of clinical, immunological and/or virological criteria. For patient in treatment failure on PI-based 2nd line therapy, there is no alternative ARV regimen today in Cambodia.
This operational research, which started at the beginning of 2013, aims to evaluate the PI-based 2nd line antiretroviral regimen national program (individual and structural factors and virological efficacy). The specific objective are i) to identify risk factors associated to treatment failure on PI-based 2nd line, ii) to identify individual risk factors and structural factors associated with non-adherence in patients treated with PI-2nd line based regimens, iii) to describe the ARV resistance profiles of patients experiencing virological failure on PI-based 2nd line, iv) to design alternative salvage ARV regimens.
The description of the profile of ARV resistance in patients with virological failure is expected to develop a plan for the 3rd line in Cambodia where CRF01_AE subtype is predominant. It will also strengthen the national laboratory through implementation of qualitative/quantitative social science tools and virological tools (HIV RNA VL, Biocentric/ANRS assay, HIV Drug resistance).