@article{fdi:010060654,
  title = {{P}opulation-based monitoring of emerging {HIV}-1 drug resistance on antiretroviral therapy and associated factors in a sentinel site in {C}ameroon : low levels of resistance but poor programmatic performance},
  author = {{B}illong, {S}. {C}. and {F}okam, {J}. and {A}ghokeng {F}obang, {A}velin and {M}ilenge, {P}. and {K}embou, {E}. and {A}bessouguie, {I}. and {M}eva'a-{O}nglene, {F}. {B}. and {Z}oung-{K}anyi {B}issek, {A}. {C}. and {C}olizzi, {V}. and {M}poudi, {E}. {N}. and {E}lat, {J}. {B}. {N}. and {S}hiro, {K}. {S}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {S}cale-up of antiretroviral therapy ({ART}) in resource-limited settings has drastically reduced {HIV}-related morbidity and mortality. {H}owever, challenges in long-term {ART}, adherence and {HIV} drug resistance ({HIVDR}) itself, require monitoring to limit {HIVDR} emergence among {ART}-experienced populations, in order to ensure regimen efficacy. {M}ethods: {A} longitudinal study was conducted from 2009-2011 in a cohort of 141 {HIV}-infected adult patients (aged >21) at the national social insurance centre hospital in {Y}aounde, {C}ameroon. {A}s per-{WHO} {HIVDR} protocol, {HIV}-1 protease-reverse transcriptase genotyping was performed at baseline and at endpoint (12 months) on first-line {ART} using {V}iro{S}eq ({TM}) {G}enotyping kit. {R}esults: {A}t baseline, a prevalence of 3.6% (5/139) {HIVDR} was observed [protease inhibitors {M}46{I} (1/5), {G}73{A} (1/5), {L}90{LM} (1/5); nucleoside reverse transcriptase inhibitors: {M}184{V} (1/5), {T}215{F} (1/5); non-nucleoside reverse transcriptase inhibitors: {K}103{N} (1/5), {Y}181{Y}/{C} (2/5), {M}230{ML} (1/5)]. {A}t endpoint, 54.0% (76) patients were followed-up, 9.2% (13) died, and 3.5% (5) transferred, 38.5% (47) lost to follow-up ({LTFU}). 69.7% (53/76) of those followed-up had viremia <40 copies/ml and 90.8% (69/76) <1000 copies/ml. 4/7 patients with viremia >= 1000 copies/ml harbored {HIVDR} (prevalence: 5.3%; 4/76), with {M}184{V}/{I} (4/4) and {K}103{K}/{N} (3/4) being the most prevalent mutations. {LTFU} was favored by costs for consultation/laboratory tests, drug shortages, workload (physician/patient ratio: 1/180) and community disengagement. {C}onclusions: {L}ow levels of {HIVDR} at baseline and at endpoint suggest a probable effectiveness of {ART} regimens used in {C}ameroon. {H}owever the possible high rate of {HIVDR} among {LTFU}s limited the strengths of our findings. {E}valuating {HIVDR} among {LTFU}, improving adherence, task shifting, subsidizing/harmonizing costs for routine follow-up, are urgent measures to ensure an improved success of the country {ART} performance.},
  keywords = {{CAMEROUN}},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {8},
  numero = {8},
  pages = {e72680},
  ISSN = {1932-6203},
  year = {2013},
  DOI = {10.1371/journal.pone.0072680},
  URL = {https://www.documentation.ird.fr/hor/fdi:010060654},
}