Viral suppression in adults, adolescents and children receiving antiretroviral therapy in Cameroon: adolescents at high risk of virological failure in the era of “test and treat”

Abstract Background After the launching of the « Test & Treat » strategy and the wider accessibility to viral load (VL), evaluating virological success (VS) would help in meeting the UNAIDS targets by 2020 in Cameroon. Setting and methods Cross-sectional study conducted in the Chantal BIYA Inter...

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Main Authors: Joseph Fokam, Samuel Martin Sosso, Bouba Yagai, Serge Clotaire Billong, Rina Estelle Djubgang Mbadie, Rachel Kamgaing Simo, Serge Valery Edimo, Alex Durand Nka, Aline Tiga Ayissi, Junie Flore Yimga, Désiré Takou, Sylvie Moudourou, Marinette Ngo Nemb, Jean-Bosco Nfetam Elat, Maria-Mercedes Santoro, Carlo-Federico Perno, Vittorio Colizzi, Alexis Ndjolo
Format: Article
Language:English
Published: BMC 2019-11-01
Series:AIDS Research and Therapy
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12981-019-0252-0
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Summary:Abstract Background After the launching of the « Test & Treat » strategy and the wider accessibility to viral load (VL), evaluating virological success (VS) would help in meeting the UNAIDS targets by 2020 in Cameroon. Setting and methods Cross-sectional study conducted in the Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management (CIRCB), Yaoundé, Cameroon; data generated between October 2016 and August 2017 amongst adults, adolescents and children at 12, 24, 36 and ≥ 48 months on ART. VS was defined as < 1000 copies/mL of blood plasma and controlled viremia as VL < 50 copies/mL. Data were analysed by SPSS; p < 0.05 considered as significant. Results 1946 patients (70% female) were enrolled (1800 adults, 105 adolescents, 41 children); 1841 were on NNRTI-based and 105 on PI-based therapy; with 346 patients at M12, 270 at M24, 205 at M36 and 1125 at ≥ M48. The median (IQR) duration on was 48 months (24–48). Overall, VS was 79.4% (95% CI 77.6–81.2) and 67.1% (95% CI 64.9–69.1) had controlled viral replication. On NNRTI-based, VS was 79.9% vs. 71.4% on PIs-based, p = 0.003. By ART duration, VS was 84.1% (M12), 85.9% (M24), 75.1% (M36) and 77.2% (≥ M48), p = 0.001. By age, VS was 75.6% (children), 53.3% (adolescents) and 81.1% (adults), p < 0.001. Conclusions In this sub-population of patients receiving ART in Cameroon, about 80% might be experiencing VS, with declining performance at adolescence, with NNRTI-based regimens, and as from 36 months on ART. Thus, improving VS may require an adapted adherence support mechanism, especially for adolescents with long-term treatment in resource-limited settings.
ISSN:1742-6405