Boullé C., Guichet E., Kouanfack C., Aghokeng Fobang Avelin, Onambany B., Ikaka C.M., Ngock E., Tsoumsta L., Msellati Philippe, Mpoudi-Ngolé E., Peeters Martine, Delaporte E., Laurent Christian. (2016). Virologic failure and human immunodeficiency virus drug resistance in rural Cameroon with regard to the UNAIDS 90-90-90 treatment targets. Open Forum Infectious Diseases, 3 (4), ofw233 [7 p.]. ISSN 2328-8957.
Titre du document
Virologic failure and human immunodeficiency virus drug resistance in rural Cameroon with regard to the UNAIDS 90-90-90 treatment targets
Année de publication
2016
Auteurs
Boullé C., Guichet E., Kouanfack C., Aghokeng Fobang Avelin, Onambany B., Ikaka C.M., Ngock E., Tsoumsta L., Msellati Philippe, Mpoudi-Ngolé E., Peeters Martine, Delaporte E., Laurent Christian
Source
Open Forum Infectious Diseases, 2016,
3 (4), ofw233 [7 p.] ISSN 2328-8957
Background. In rural Africa, data on virologic effectiveness of antiretroviral treatment (ART) are not sufficient to assess the gap with the UNAIDS 90-90-90 treatment targets. We investigated the prevalences of unsuppressed viral load and antiretroviral drug resistance and the profile of genotypic resistance mutations among patients routinely treated in rural Cameroon. Methods. A cross-sectional study was performed in 2013-2014 among patients sup or eq. 15 years and on first-line ART for sup. or eq. 6 months in a district hospital. Patients were offered free access to human immunodeficiency virus viral load testing. Genotypic drug resistance testing was done when the viral load was >1000 copies/mL. Multivariate logistic regression models were used to assess the relation-ship of unsuppressed viral load or antiretroviral drug resistance with sociodemographic and medical characteristics. Results. Of 407 patients (women 74.9%, median age 41.8 years, median time on ART 29.2 months), 96 (23.6%; 95% confidence interval [CI], 19.5-28.0) had unsuppressed viral load and 74 (18.2%; 95% CI, 14.6-22.3) had antiretroviral drug resistance. The prevalences of unsuppressed viral load and resistance increased with time on ART, from 12.0% and 8.0% in the 6- to 12-month group to 31.3% and 27.1% in the >72-month group, respectively. All 74 patients with antiretroviral drug resistance were resistant to nonnucleoside reverse-transcriptase inhibitors, and 57 of them were also resistant to nucleoside reverse-transcriptase inhibitors. Conclusions. Our estimations were among the highest observed in the west and central African region. The proportion of patients with virologic failure should be divided at least by 2 to reach the UNAIDS 90-90-90 treatment targets.
Plan de classement
Médecine [050MEDECI]
;
Maladies sexuellement transmissibles [052MALTRA03]
Localisation
Fonds IRD [F B010085504]
Identifiant IRD
fdi:010085504
