@article{fdi:010093136,
  title = {{N}ationwide estimates of viral load suppression and acquired {HIV} drug resistance in {C}ameroon},
  author = {{T}chouwa, {G}.{F}. and {E}ymard-{D}uvernay, {S}abrina and {C}ournil, {A}mandine and {L}amare, {N}. and {S}errano, {L}. and {B}utel, {C}hristelle and {B}ertagnolio, {S}. and {M}poudi-{N}gole, {E}. and {R}aizes, {E}. and {A}ghokeng {F}obang, {A}velin and {EHRICA} {S}tudy {G}roup},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {P}opulation-based studies to estimate viral load ({VL}) suppression and rate of acquired {HIV} drug resistance ({ADR}) are essential in sub-{S}aharan {A}frica. {W}e conducted the first nationally representative study estimating {VL} suppression and {ADR} in {C}ameroon.
{M}ethods: {E}ligible participants were patients on antiretroviral therapy ({ART}) for 12 to 24 months ({ART} 12-24) or 48 to 60 months ({ART} 48-60). {ART} 12-24 participants were recruited from 24 randomly selected clinics in both urban and rural regions. {ART} 48-60 participants were recruited from 7 urban clinics. {R}ecruitment occurred from {F}ebruary to {A}ugust 2015. {D}ried blood spots ({DBS}s) and plasma specimens were collected and tested for {HIV}-1 {RNA} level and presence of drug resistance mutations ({DRM}) when {VL} >= 1000 copies/ml. {R}esults: {O}verall, 1064 {ART} 12-24 and 388 {ART} 48-60 participants were recruited. {V}iral suppression in the {ART} 12-24 group was 72.1% (95% {CI}: 66.3-77.2) overall, 75.0% (65.2-82.7) in urban sites, and 67.7% (58.3-75.8) in rural sites. {I}n the {ART} 48-60 group, viral suppression was 67.7% (55.8-77.7). {O}verall, {HIV} drug resistance ({HIVDR}) was 17.7% (15.1-20.6) and 28.3% (17.4-42.5) in the {ART} 12-24 and {ART} 48-60 groups, respectively. {H}owever, among patients with {VL} >= 1000 copies/ml, {HIVDR} was identified in 63.3% (52.0-73.3) of {ART} 12-24 patients, and in 87.7% (67.4-96.1) of {ART} 48-60 patients. {C}onclusions: {R}esults of this first nationwide study indicate alarming levels of virological failure and {ADR} in {C}ameroon. {B}etter {ART} management is urgently needed and should focus on improving {ART} adherence, availability of {VL} monitoring, and more timely switches to second-line {ART}.},
  keywords = {{CAMEROUN}},
  booktitle = {},
  journal = {{EC}linical{M}edicine},
  volume = {1},
  numero = {},
  pages = {21--27},
  ISSN = {2589-5370},
  year = {2018},
  DOI = {10.1016/j.eclinm.2018.06.005},
  URL = {https://www.documentation.ird.fr/hor/fdi:010093136},
}