High risk of virologic failure among HIV-infected children and adolescents routinely followed-up in Littoral region of Cameroon.

Autor: Mbébi Enoné PJ; Faculty of Sciences, Department of Animal Biology and Physiology, University of Douala, Douala, Cameroon., Penda CI; Faculty of Medicine and Pharmaceutical Sciences, Clinical Sciences Department, University of Douala, Douala, Cameroon.; Accredited HIV Care Center, Laquintinie Hospital of Douala, Douala, Cameroon., Ngondi G; Faculty of Medicine and Pharmaceutical Sciences, Biological Sciences Department, University of Douala, Douala, Cameroon.; Biological Laboratory, Laquintinie Hospital of Douala, Douala, Cameroon., Fokam J; Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon.; Faculty of Health Sciences, Department of Medical Laboratory Science, University of Buea, Buea, Cameroon., Ebong SB; Faculty of Sciences, Department of Animal Biology and Physiology, University of Douala, Douala, Cameroon., Mekoulou Ndongo J; Faculty of Sciences, Department of Animal Biology and Physiology, University of Douala, Douala, Cameroon., Essangui Same EG; Faculty of Medicine and Pharmaceutical Sciences, Biological Sciences Department, University of Douala, Douala, Cameroon., Ndjengue Nson LS; Accredited HIV Care Center, Laquintinie Hospital of Douala, Douala, Cameroon., Mandengue SH; Faculty of Sciences, Department of Animal Biology and Physiology, University of Douala, Douala, Cameroon., Eboumbou Moukoko CE; Faculty of Medicine and Pharmaceutical Sciences, Biological Sciences Department, University of Douala, Douala, Cameroon.; Laboratory of Parasitology, Mycology and Virology, Postgraduate Training Unit for Health Sciences, Postgraduate School for Pure and Applied Sciences, University of Douala, Douala, Cameroon.; Centre Pasteur of Cameroon, Yaounde, Cameroon.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Aug 10; Vol. 18 (8), pp. e0289426. Date of Electronic Publication: 2023 Aug 10 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0289426
Abstrakt: Virological response to antiretroviral therapy (ART) remains a challenge for HIV-infected children and adolescents due to non-optimization of pediatric ART for resource-limited settings. In this study, we aimed to investigate factors associated with virologic failure (VF) in HIV-infected-children and adolescents on ART in Cameroon. A prospective patient-based cohort study was conducted among HIV-infected children (0-9 years) and adolescents (10-19 years) followed-up between November 2018 and October 2019 in 38 healthcare centers located in the Littoral region of Cameroon. The 1st viral load (VL) was assessed after 6 months of ART initiation and the 2nd VL between 3 and 6 six months later in patients with VL ≥1000 copies/ml in accordance with the national algorithm using Abbott Real-Time HIV-1 Viral Load Assay. Multivariate analyses were performed to identify the determinants of higher risk of VF. Of 1,029 HIV-infected children and adolescents (393 children and 636 adolescents), 801 (77.8%) cumulatively presented with VL <1000 copies/mL within 12 months on ART. Adolescents were more likely to have VF than children (24.5% vs 18.3%, OR: 1.39; 95%CI: 1.00-1.93; p = 0.047). Patients followed-up in decentralized care units were significantly more likely to have VF compared to those attending the accredited treatment centers (26.1% vs 16.6%, OR: 1.88, 95%CI: 1.37-2.58; p<0.001). Our findings show a high rate of VL suppression (VLS, 77.8%) among HIV-infected children and adolescents, albeit lower than the established target of 90%. Being adolescent and patients followed in the decentralized care units are high risk factors for VF, thereby necessitating routine therapeutic education of patients and guardians in resource limited countries to improve VLS.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Mbébi Enoné et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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