Alitalia (Italy)

HIV-1 drug resistance (HIVDR) surveillance among individuals failing antiretroviral therapy (ART) is essential to selecting optimal ART-combinations for use in a public health approach in low-middle-income countries (LMICs) where routine HIVDR-testing remains limited. This study describes patterns of acquired drug resistance (ADR) and potentially active drugs for subsequent ART regimens in individuals failing treatment in Cameroon. We conducted a cross-sectional, laboratory-based sentinel study among ART-failing individuals from October 2022 through April 2023 at the "Chantal Biya" International Reference Centre, Yaoundé-Cameroon. Individual samples with confirmed virological failure were sequenced in HIV-1 protease and reverse-transcriptase genes using Sanger sequencing and analysed using Stanford HIVdatabase.v.9.4. Overall, 203 individuals were enrolled, median [IQR] age 37 [16-47] years with 58.1% (118/203) being female. Median [IQR] duration on ART was 10 [6.9-13.3] years, with majority failing second-line (78.7%; 160/203). HIVDR rate was 85.3% (29/34) and 88.1% (140/160) in those failing first-line and second-line therapy respectively (p = 0.7). NNRTI, NRTI and PI/r resistance in individuals failing first-line ART was 85.3% (9/34), 82.4% (28/34) and 2.9% (1/34) respectively. In second-line failure, NNRTI, NRTI and PI/r resistance was 86.8% (138/160), 84.9% (135/160) and 47.17% (75/160) respectively. NRTI-NNRTI dual-class-resistance was 82.4% (28/34) after first-line and 84.3% (134/160) after second-line (p = 0.842), while triple-class-resistance was 2.9% (1/34) after first-line and 45.3% (72/160) after second-line (p < 0.0001). After first-line, TDF and AZT maintained potential efficacy in respectively 53.4% (18/34) and 46.7% (16/34) of individuals, while 46.7% (16/34) had cross-resistance to second-generation NNRTI. After second-line failure, 95.6% (153/160) maintained DRV/r efficacy, as compared to 67.3% for ATV/r (p < 0.0002), 73.9% for LPV/r (p < 0.0002), and 34.7% (56/160) for RPV/DOR. Among ART-failing individuals in Cameroon, levels of ADR are high with significant levels of cross-resistance to second-generation NNRTI, hence potentially jeopardizing the use of long-acting cabotegravir/rilpivirine. Furthermore, HIVDR testing could be considered from first-line failure in such settings, but chiefly following second-line failure wherein triple-class-resistance is common and calls for novel antiretrovirals in similar LMICs.

RODiO is an innovative mission concept which has successfully concluded phase A study in the framework of the ALCOR program, funded and coordinated by the Italian Space Agency. The main objectives of the mission are i) in-orbit technological demonstration of Distributed Synthetic Aperture Radar (DSAR) concept; ii) in-orbit-demonstration of a novel hybrid rocket propulsion system for formation reconfiguration and iii) the validation of new SAR measures and products suitable for a commercial/scientific downstream. To reach these objectives, the mission relies on a cluster of 4 CubeSats. All the Cubesats embark a receiving-only X-band SAR instrument able to collect bistatic echoes exploiting PLATiNO-1 (PLT-1) SAR satellite as an opportunity illuminator, and one of the CubeSats hosts a novel hybrid rocket propulsion unit that enables orbit reconfiguration. As conceived, the mission foresees that all the Cubesats flies both in formation with PLT-1, at a safe distance of tens of km, but also formation-flying techniques are used to keep all the CubeSats in the cluster within an overall envelope of a few hundred meters, until the orbit reconfiguration maneuvers occurs, in which one Cubesat flies far away in across track direction. The paper shows an overview of the mission with specific focus on space segment.