@article{fdi:010063631,
  title = {{A}ntiretroviral treatment outcome in {HIV}-1-infected patients routinely followed up in capital cities and remote areas of {S}enegal, {M}ali and {G}uinea-{C}onakry},
  author = {{D}iouara, {A}. {A}. {M}. and {N}diaye, {H}. {D}. and {G}uindo, {I}. and {B}angoura, {N}. and {C}isse, {M}. and {E}dmond, {T}. and {B}ougoudogo, {F}. and {M}boup, {S}. and {P}eeters, {M}artine and {A}youba, {A}hidjo and {K}ane, {N}. {C}. {T}.},
  editor = {},
  language = {{ENG}},
  abstract = {{I}ntroduction: {A}ccess to antiretroviral treatment ({ART}) becomes more and more effective in resource-limited settings ({RLS}). {H}owever, this global effort would be even more profitable if the access to laboratory services especially in decentralized settings was strengthened. {W}e report the virological outcome and {HIV}-1 drug resistance in three {W}est {A}frican countries using dried blood spots ({DBS}) samples. {M}ethods: {W}e included {HIV}-1-infected adults on {ART} >= 6 months and followed up in capital cities and decentralized sites in {S}enegal, {M}ali and {G}uinea-{C}onakry. {P}atients were consecutively enrolled and {DBS} were collected in field conditions and kept at ambient temperature before transfer to the reference laboratory. {V}iral load ({VL}) was quantified using the {N}ucli{SENS} {E}asy{Q} {HIV}-1 v1.2. {G}enotyping of {HIV}-1 pol gene was performed using in-house protocol. {R}esults: {O}f the 407 participants, 119, 152 and 136 were from {S}enegal, {M}ali and {G}uinea-{C}onakry, respectively. {T}he median treatment duration was 36 months [{IQR}: 6-136]. {V}irological failure ({VF}) ({VL} >= 3log(10) copies/ m{L}) was observed in 26% (95% confidence interval ({CI}), 18-35; n=31), 11% (95% {CI}, 6-17; n = 16) and 24% (95% {CI}, 17-32; n = 33) of patients in {S}enegal, {M}ali and {G}uinea-{C}onakry, respectively (p = 0.001). {O}f samples presenting {VL}] 3log(10) copies/ m{L} (n = 80), 70 were successfully genotyped. {A}t least one drug resistance mutation ({DRM}) was detected in the following proportions: 70% (95% {CI}, 50-86; n = 19), 93% (95% {CI}, 68-100; n = 14) and 68% (95% {CI}, 48-84; n = 19) in {S}enegal, {M}ali and {G}uinea-{C}onakry, respectively (p = 0.22). {T}wenty-six per cent (26%; 95% {CI}, 16-38; n = 18) of patients in {VF} harboured wild-type viruses, which is likely indicative of weak adherence. {P}hylogenetic analysis showed the predominance of {CRF}02_{AG} subtype (73%; 95% {CI}, 61-83; n = 51). {C}onclusions: {W}e describe the {ART} outcome in capital and rural settings of {S}enegal, {M}ali and {G}uinea-{C}onakry. {O}ur results in all of the three countries highlight the need to reinforce the {ART} adherence in order to minimize the occurrence of drug resistance. {I}n addition, these findings provide additional evidence that the use of {DBS} as a sampling support could assist virological monitoring of patients on {ART} in remote areas.},
  keywords = {{HIV}-1 drug resistance ; viral load ; {HIV}-1 genetic diversity ; dried blood spots ; remote areas ; {W}est {A}frica ; {AFRIQUE} {DE} {L}'{OUEST} ; {SENEGAL} ; {MALI} ; {GUINEE}},
  booktitle = {},
  journal = {{J}ournal of the {I}nternational {A}ids {S}ociety},
  volume = {17},
  numero = {},
  pages = {art. 19315 [9 p.]},
  ISSN = {1758-2652},
  year = {2014},
  DOI = {10.7448/ias.17.1.19315},
  URL = {https://www.documentation.ird.fr/hor/fdi:010063631},
}