@article{fdi:010060353,
  title = {{R}isk of virological failure and drug resistance during first and second-line antiretroviral therapy in a 10-year cohort in {S}enegal : results from the anrs 1215 cohort},
  author = {{B}eaudrap, {P}ierre de and {T}hiam, {M}. and {D}iouf, {A}. and {T}oure-{K}ane, {C}. and {N}gom-{G}ueye, {N}.{F}. and {V}idal, {N}icole and {M}boup, {S}. and {N}doye, {I}. and {S}ow, {P}.{S}. and {D}elaporte, {E}ric},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {I}n 1998, {S}enegal launched one of {A}frica's first anti-retroviral therapy ({ART}) programs. {S}ince then, the number of treated patients in {A}frica has substantially increased thanks to simplification in treatment management. {A}lthough good outcomes over the first years of {ART} have been observed in sub-{S}aharan {A}frica, little is known about the long-term (>5 years) risks of virological failure and drug resistance and about second-line treatment response. {M}ethods: {P}atients from the {ANRS}-1215 cohort in {S}enegal, started with either one nonnucleoside reverse transcriptase inhibitor or indinavir, a first-generation nonboosted protease inhibitor, followed for >6 months and having >1 viral load ({VL}) measurement were included. {V}irological failure was defined as 2 consecutive {VL} measurements >1000 copies/m{L}. {R}esults: {O}f the 366 patients included, 89% achieved a {VL} <500 copies/m{L}. {T}he risk of virological failure at 12, 24, and 60 months was 5%, 16%, and 25%, being higher in younger patients ({P} = 0.05), those receiving a protease inhibitor-containing regimen ({P} = 0.05), and those with lower adherence ({P} = 0.03). {T}he risk of resistance to any drug at 12, 24, and 60 months was 3%, 11%, and 18%. {A}fter virological failure, 60% of the patients were switched to second-line treatments. {A}lthough 81% of the patients achieved virological success, the risk of virological failure was 27% at 24 months, mostly in patients with multiple resistances. {C}onclusions: {I}n this cohort, virological outcomes for first-line treatments were good compared with those from high-resource settings. {H}owever, the rate of virological failure for second-line treatment was high, probably because of accumulation of resistances.},
  keywords = {{HIV} ; antiretroviral therapy ; virological response ; drug resistance ; sub-{S}aharan {A}frica ; {SENEGAL} ; {AFRIQUE} {SUBSAHARIENNE}},
  booktitle = {},
  journal = {{JAIDS}-{J}ournal of {A}cquired {I}mmune {D}eficiency {S}yndromes},
  volume = {62},
  numero = {4},
  pages = {381--387},
  ISSN = {1525-4135},
  year = {2013},
  DOI = {10.1097/{QAI}.0b013e31827a2a7a},
  URL = {https://www.documentation.ird.fr/hor/fdi:010060353},
}