Nationwide Estimates of Viral Load Suppression and Acquired HIV Drug Resistance in Cameroon
| Autor: | Elliot Raizes, Amandine Cournil, Gaëlle F. Tchouwa, Christelle Butel, Laetitia Serrano, Avelin F. Aghokeng, Nadine Lamare, Sabrina Eymard-Duvernay, Silvia Bertagnolio, Eitel Mpoudi-Ngole |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Population Drug resistance 03 medical and health sciences 0302 clinical medicine Viral load suppression Internal medicine medicine 030212 general & internal medicine Viral suppression Cameroon education Dried blood education.field_of_study business.industry HIV General Medicine 030112 virology Antiretroviral therapy Art adherence 3. Good health business Viral load HIV drug resistance Research Paper |
| Zdroj: | EClinicalMedicine |
| ISSN: | 2589-5370 |
| Popis: | Background Population-based studies to estimate viral load (VL) suppression and rate of acquired HIV drug resistance (ADR) are essential in sub-Saharan Africa. We conducted the first nationally representative study estimating VL suppression and ADR in Cameroon. Methods Eligible participants were patients on antiretroviral therapy (ART) for 12 to 24 months (ART 12–24) or 48 to 60 months (ART 48–60). ART 12–24 participants were recruited from 24 randomly selected clinics in both urban and rural regions. ART 48–60 participants were recruited from 7 urban clinics. Recruitment occurred from February to August 2015. Dried blood spots (DBSs) and plasma specimens were collected and tested for HIV-1 RNA level and presence of drug resistance mutations (DRM) when VL ≥ 1000 copies/ml. Results Overall, 1064 ART 12–24 and 388 ART 48–60 participants were recruited. Viral suppression in the ART 12–24 group was 72.1% (95% CI: 66.3–77.2) overall, 75.0% (65.2–82.7) in urban sites, and 67.7% (58.3–75.8) in rural sites. In the ART 48–60 group, viral suppression was 67.7% (55.8–77.7). Overall, HIV drug resistance (HIVDR) was 17.7% (15.1–20.6) and 28.3% (17.4–42.5) in the ART 12–24 and ART 48–60 groups, respectively. However, among patients with VL ≥ 1000 copies/ml, HIVDR was identified in 63.3% (52.0–73.3) of ART 12–24 patients, and in 87.7% (67.4–96.1) of ART 48–60 patients. Conclusions Results of this first nationwide study indicate alarming levels of virological failure and ADR in Cameroon. Better ART management is urgently needed and should focus on improving ART adherence, availability of VL monitoring, and more timely switches to second-line ART. |
| Databáze: | OpenAIRE |
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