Retrospective Review of Virologic and Immunologic Response in Treatment-Experienced Patients on Third-Line HIV Therapy in Lusaka, Zambia

• Main Authors: Paul Msanzya Zulu MBChB, Mmed, Mona-Gekanju Toeque MD, MPH, Lottie Hachaambwa MBChB, Lameck Chirwa MSc, Sombo Fwoloshi MBChB, Mmed, Mpanji Siwingwa BSC, MPH, Melody Mbewe MClini.Pharm, Joelle I Rosser MD, Kristen A Stafford MPH, PhD, Brianna Lindsay PhD, Lloyd Mulenga MBChB, PhD, MSc, Cassidy W Claassen MD, MPH
• Format: Article
• Language: English
• Published: SAGE Publishing 2021-06-01
• Series: Journal of the International Association of Providers of AIDS Care
• Online Access: https://doi.org/10.1177/23259582211022463

Established antiretroviral therapy (ART) programs in sub-Saharan Africa have well-defined first-and second-line therapies but no standard third-line ART regimen. The impact of third-line ART on patients with multiclass-resistant HIV in resource-limited settings has not been well characterized. We conducted a retrospective review of patients on third-line ART at the University Teaching Hospital in Lusaka, Zambia. We assessed virologic and immunologic outcomes following 6 months of third-line therapy and found among those with a documented viral load, viral suppression (≤1000 copies/ml) at 24 weeks was 95% (63/66) with a mean increase in CD4 count of 116 cells/mm 3 and viral suppression of 63% (63/100) by imputation of missing data. This study suggests that third-line therapy is clinically and virologically effective among patients with multiclass-resistance in a resource-limited setting in sub-Saharan Africa.