Guichet Emilande, Aghokeng Fobang Avelin, Serrano L., Bado G., Toure-Kane C., Eymard-Duvernay Sabrina, Villabona-Arenas C. J., Delaporte Eric, Ciaffi L., Peeters Martine. (2016). High viral load and multidrug resistance due to late switch to second-line regimens could be a major obstacle to reach the 90-90-90 UNAIDS objectives in Sub-Saharan Africa : Short communication. Aids Research and Human Retroviruses, 32 (12), p. 1159-1162. ISSN 0889-2229.
Titre du document
High viral load and multidrug resistance due to late switch to second-line regimens could be a major obstacle to reach the 90-90-90 UNAIDS objectives in Sub-Saharan Africa : Short communication
Année de publication
2016
Auteurs
Guichet Emilande, Aghokeng Fobang Avelin, Serrano L., Bado G., Toure-Kane C., Eymard-Duvernay Sabrina, Villabona-Arenas C. J., Delaporte Eric, Ciaffi L., Peeters Martine
Source
Aids Research and Human Retroviruses, 2016,
32 (12), p. 1159-1162 ISSN 0889-2229
In the context of lifelong antiretroviral treatment (ART) as early as possible and to end the HIV/AIDS epidemic as a public health treat by 2030, it is important to evaluate the potential risk of transmission of HIV-1 drug resistance (HIVDR) in resource-limited countries (RLCs). Since HIV transmission is driven by HIV-1 RNA viral load (VL), we studied the association between plasma VL and HIVDR profiles in 451 adults failing first-line ART from the 2LADY-ANRS12169/EDCTP trial in Burkina Faso, Cameroon, and Senegal. Median duration on first-line ART was 49 months (IQR: 33-69) and 91% patients were asymptomatic. Genotypic drug resistance testing was successful for 446 patients and 98.7% of them were resistant to at least one of the first-line drugs; 40.6% and 55.8% were resistant to two or three drugs of their ongoing first-line ART, respectively. The median VL was higher in patients with HIVDR to all ongoing first-line drugs than in those still susceptible to at least one drug; 4.7 log(10) copies/ml (IQR: 4.3-5.2) versus 4.2 log(10) copies/ml (IQR: 3.7-4.7), respectively (p<.001). The proportion of patients with HIVDR to all ongoing first-line drugs was highest (77.9% [95/122]) in patients with VL >5.0 log(10) copies/ml. High rates of cross-resistance to other nucleoside reverse-transcriptase inhibitors were observed and were also highest in patients with high VL. Without improvement of patient monitoring to avoid late switch to second-line regimens, a potential new epidemic caused by HIVDR strains could emerge in sub-Saharan Africa and compromise all efforts to reach 90-90-90 UNAIDS objective by 2020.
Plan de classement
Santé : généralités [050]
;
Entomologie médicale / Parasitologie / Virologie [052]
Description Géographique
BURKINA FASO ; CAMEROUN ; SENEGAL ; AFRIQUE SUBSAHARIENNE
Localisation
Fonds IRD [F B010068794]
Identifiant IRD
fdi:010068794
