@article{fdi:010061475,
  title = {{T}he vulnerability of men to virologic failure during antiretroviral therapy in a public routine clinic in {B}urkina {F}aso},
  author = {{P}enot, {P}. and {H}ema, {A}. and {B}ado, {G}. and {K}abore, {F}. and {S}ore, {I}. and {S}ombie, {D}. and {T}raore, {J}. {R}. and {G}uiard-{S}chmid, {J}. {B}. and {F}ontanet, {A}. and {S}lama, {L}. and {S}awadogo, {A}. {B}. and {L}aurent, {C}hristian},
  editor = {},
  language = {{ENG}},
  abstract = {{I}ntroduction: {G}ender differences in antiretroviral therapy ({ART}) outcomes are critical in sub-{S}aharan {A}frica. {W}e assessed the association between gender and virologic failure among adult patients treated in a public routine clinic (one of the largest in {W}est {A}frica) in {B}urkina {F}aso. {M}ethods: {W}e performed a case-control study between {J}uly and {O}ctober 2012 among patients who had received {ART} at the {B}obo {D}ioulasso {D}ay {C}are {U}nit. {P}atients were eligible if they were 15 years or older, positive for {HIV}-1 or {HIV}-1 + 2, and on first-line {ART} for at least six months. {C}ases were all patients with two consecutive {HIV} loads >1000 copies/m{L} ({B}iocentric {G}eneric or {A}bbott {R}eal {T}ime assays), or one {HIV} load >1000 copies/m{L} associated with immunologic or clinical failure criteria. {C}ontrols were all patients who only had {HIV} loads {B}300 copies/m{L}. {T}he association between gender and virologic failure was assessed using a multivariate logistic regression, adjusted on age, level of education, baseline {CD}4+ {T} cell count, first and current antiretroviral regimens and time on {ART}. {R}esults: {O}f 2303 patients (74.2% women; median age: 40 years; median time on {ART}: 34 months), 172 had virologic failure and 2131 had virologic success. {A}mong the former, 130 (75.6%) had confirmed virologic failure, 38 (22.1%) had viroimmunologic failure, and four (2.3%) had viro-clinical failure. {T}he proportion of men was significantly higher among the cases than among the controls (37.2% vs. 24.9%; p<0.001). {C}ompared to controls, cases were also younger, more immunodeficient at {ART} initiation, less likely to receive a protease inhibitor-based antiretroviral regimen and had spent a longer period of time on {ART}. {A}fter adjustment, male gender remained strongly associated with virologic failure (odds ratio 2.52, 95% {CI}: 1.77 - 3.60; p<0.001). {C}onclusions: {M}en on {ART} appeared more vulnerable to virologic failure than women. {A}dditional studies are needed to confirm the poorer prognosis of men in this setting and to determine the causes for their vulnerability in order to optimize {HIV} care. {F}rom now on, efforts should be made to support the adherence of men to {ART} in the {A}frican setting.},
  keywords = {{HIV} ; antiretroviral ; efficacy ; virologic failure ; gender ; {A}frica ; {BURKINA} {FASO}},
  booktitle = {},
  journal = {{J}ournal of the {I}nternational {A}ids {S}ociety},
  volume = {17},
  numero = {},
  pages = {18646},
  ISSN = {1758-2652},
  year = {2014},
  DOI = {10.7448/ias.17.1.18646},
  URL = {https://www.documentation.ird.fr/hor/fdi:010061475},
}