Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model

Autor: Ezechiel Ngoufack Jagni Semengue, Joseph Fokam, Naomi-Karell Etame, Evariste Molimbou, Collins Ambe Chenwi, Désiré Takou, Leonella Mossiang, Alain P. Meledie, Bouba Yagai, Alex Durand Nka, Beatrice Dambaya, Georges Teto, Aude Christelle Ka’e, Grâce Angong Beloumou, Sandrine Claire Djupsa Ndjeyep, Aissatou Abba, Aurelie Minelle Ngueko Kengni, Michel Carlos Tommo Tchouaket, Nounouce Pamen Bouba, Serge-Clotaire Billong, Samuel Martin Sosso, Vittorio Colizzi, Carlo-Federico Perno, Charles Kouanfack, Anne-Cecile Zoung-Kanyi Bissek, Emmanuel Eben-Moussi, Maria Mercedes Santoro, Francesca Ceccherini-Silberstein, Alexis Ndjolo
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Viruses, Vol 15, Iss 1, p 18 (2022)
Druh dokumentu: article
ISSN: 1999-4915
DOI: 10.3390/v15010018
Popis: To ensure optimal prescribing practices in the dolutegravir-era in Cameroon, we compared first-line virological response (VR) under tenofovir + lamivudine + dolutegravir (TLD) according to prior exposure to tenofovir + lamivudine + efavirenz (TLE). A facility-based survey was conducted among patients initiating antiretroviral therapy (ART) with TLD (I-TLD) versus those transitioning from TLE to TLD (T-TLD). HIV viral load was performed and unsuppressed participants (VL > 1000 copies/mL) had genotyping performed by Sanger sequencing. Of the 12,093 patients followed, 310 (mean-age: 41 ± 11 years; 52.26% female) complied with study criteria (171 I-TLD vs. 139 T-TLD). The median ART-duration was 14 (12–17) months among I-TLDs versus 28 (24.5–31) months among T-TLDs (15 (11–19) on TLE and 14 (9–15) on TLD), and 83.15% (148/178) were at WHO clinical stages I/II. The viral suppression rate (p = 0.55). VR was similar in I-TLD versus T-TLD at p > 0.05). Genotyping was successful for 72.7% (8/11), with no major mutations to integrase inhibitors found. VR is optimal under first-line TLD after 14 months, even among TLE-exposed, thus confirming the effectiveness of transitioning from TLE to TLD in similar settings, supported by strong pharmacological potency and genetic barrier of dolutegravir.
Databáze: Directory of Open Access Journals
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje