@article{fdi:010061440,
  title = {{E}xtraordinary heterogeneity of virological outcomes in patients receiving highly antiretroviral therapy and monitored with the {W}orld {H}ealth {O}rganization public health approach in {S}ub-{S}aharan {A}frica and {S}outheast {A}sia},
  author = {{A}ghokeng {F}obang, {A}velin and {M}onleau, {M}arjorie and {E}ymard-{D}uvernay, {S}abrina and {D}agnra, {A}. and {K}ania, {D}. and {N}go-{G}iang-{H}uong, {N}icole and {T}oni, {T}. {D}. and {T}oure-{K}ane, {C}. and {T}ruong, {L}. {X}. {T}. and {D}elaporte, {E}ric and {C}haix, {M}. {L}. and {P}eeters, {M}artine and {A}youba, {A}hidjo},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {T}he limited access to virological monitoring in developing countries is a major weakness of the current antiretroviral treatment ({ART}) strategy in these settings. {W}e conducted a large cross-sectional study in {B}urkina {F}aso, {C}ameroon, {C}ote d'{I}voire, {S}enegal, {T}ogo, {T}hailand, and {V}ietnam to assess virological failure and drug resistance mutations ({DRM}s) after 12 or 24 months of {ART}. {M}ethods. {B}etween 2009 and 2011, we recruited adults attending {ART} centers 10-14 months (the {M}12 group) or 22-26 months ({M}24 group) after initiating {ART}. {D}emographic and clinical data were collected on site, and viral load was measured. {S}amples with a viral load of >= 1000 copies/m{L}, considered as the failure threshold, were geno-typed for drug resistance assessment. {R}esults. {O}verall, 3935 patients were recruited (2060 at {M}12 and 1875 at {M}24). {M}edian ages varied from 32 to 42 years. {M}edian {CD}4(+) {T}-cell counts at {ART} initiation were low (99-172 cells/mu {L}). {T}he main {ART} regimens included stavudine/zidovudine plus lamivudine plus nevirapine/efavirenz. {O}verall, virological failure frequency was 11.1% for {M}12 patients and 12.4% for {M}24 patients, and 71.0% to 86.1% of these patients, respectively, had drug-resistant virus. {A}cross sites, virological failure varied from 2.9% to 20.6% in {M}12 patients and from 3.7% to 26.0% in {M}24 patients. {P}redominant {DRM}s were associated with {ART} regimens, but virus in several patients accumulated {DRM}s to drugs not received, such as abacavir, didanosine, tenofovir, etravirine, and rilpivirine. {C}onclusions. {O}ur findings show heterogeneous virological failure and illustrate that, in addition to routine access to viral load, good management of {ART} programs is even more critical to improve treatment outcomes in resource-limited countries.},
  keywords = {{HIV}-1 ; antiretroviral treatment ; monitoring ; virological outcome ; drug resistance ; {AFRIQUE} {SUBSAHARIENNE} ; {ASIE} {DU} {SUD} {EST}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {58},
  numero = {1},
  pages = {99--109},
  ISSN = {1058-4838},
  year = {2014},
  DOI = {10.1093/cid/cit627},
  URL = {https://www.documentation.ird.fr/hor/fdi:010061440},
}