Background: Viral Load (VL), CD4 T cells count and clinical signs are significant parameters for the decision of starting ARV Treatment (ART). The aim of this study is to determine the Viral Load profile of eligible patients on treatment in the centers according to the algorithm used in Kinshasa and the DRC. Methodology: Our sample consisted of 153 HIV-positive patients naïve of ART. All patients aged over 18 years were included in the study without gender discrimination. The determination of the VL was made at the laboratory of Molecular Biology of the Faculty of Medicine of the University of Kinshasa using a previously described technique. Results: Of the 153 patients included in the study, 92 (60.1%) were women. The age of the patients was in the range 18 -65 years with a mean of 37 years. Most patients (91.5%) were clinical stage 3, while the rest (8.5%) were clinical stage 4 for HIV infection. The rates of CD4+ T lymphocytes were between 8 and 915 cells/mm 3 with a median value of 180 cells/mm 3 . Seventy nine patients (86.8%) had CD4 count below 500 cells/mm 3 . The median VL of patients is 5.68 log 10 RNA copies/ml. The minimum and maximum values are respectively 0.37 and 7.95 log 10 RNA copies/ml. Conclusion: The majority of patients (63.4%) in Kinshasa begin antiretroviral treatment with a poor prognosis. The Viral loads are usually very high in these patients and CD4 quite collapsed. Indeed, the median value of CD4 for the patients is 180 cells/mm 3 for the population, while the mean value of Viral Load is 5.48 log 10 RNA copies/ml.

Conclusion A large majority of patients harbour the same ST of N. gonorrhoeae at all sites cultured. In a further 2.2% of patients there is minimal variation, which would be consistent with mutation of the porB gene during the course of infection. This uniformity is not necessarily due to infection from the same partner, as some STs circulate widely.This data adds to the understanding of the ecology of N. gonorrhoeae in an era where patients positive by nucleic acid amplification tests often receive limited culture for typing and susceptibility testing and assumptions may be made about the strain infecting uncultured sites. This data adds to knowledge of the frequency of mutation of the porB locus in vivo and the frequency of concurrent gonococcal infections with different strains.Abstract P3.263 Table 1 HIV has a genetic diversity that is equal to the complexity of its follow up of the patients. The classification of the different variants has allowed us to understand the virus, the geographical distribution and evolution of the pandemic and to better guide the follow up and the care of patients infected by HIV. Review the specifics of the HIV epidemic in the Democratic Republic of Congo (DRC), in terms of different molecular variants of HIV compared to the published location for the country. The search of the literature and abstracts presented at conferences with the subject of interest to identify different variants of HIV type 1 in the DRC on the websites of research. Online search was based on the following key words: "HIV subtype, DRC", "genotype, HIV, DRC" and "HIV strains in the Democratic Republic of Congo". It was restricted to the published literatures and presented abstracts between 1997 and 2012. According to manuscripts published since 1997, we have noticed a dominating prevalence of group M (100%) and of subtype A at 50.40% [31.2-68.9] for the entire country. In the Eastern part, variants A (44.73%) are dominant on variants C (12.20%), G (11.5%), D (9.12%) and U (7.24%). In the Center, variants A (62.57%) are followed by variants C (10.32%), H (5.02%), U (4.3%) and D (3.9%). In the Western part, variants A (40.91%) are followed by variants G (19.29%), D (10.5%), F (5.65%) and C (4.51%). For the entire country, variants are found in the following order: A (49.40%), G (10.73%), C (9.01%) and D (7.86%). The differences between and within groups are statistically significant for each variants. Several variants of HIV type 1 circulates throughout the DRC. The high number of recombinant forms (CRFs) shows the diversity and dynamics of the virus in this country. P3.264DiscorDAnT couPles in Hiv/AiDs cycle doi:10.1136/sextrans-2013-051184.0721 r n mbugua. Kenya Medical Researach Institute, Nairobi, KenyaObjectives A large proportion of new HIV infections in sub-Saharan Africa occur in stable HIV-discordant partnerships. In some couples, the strong desire to conceive a child may lead to risky behaviour despite knowledge of discordant serostatus. Our objective was to compare HIV transmission between discord...

Neuromeningeal cryptococcosis (NMC) is one of the most frequent opportunistic infections (OI) in Human Immunodeficiency Virus (HIV) infection. In Kinshasa, the latest data on cryptococcosis were published in 1996. The objective was to describe the epidemiological, clinical and biological profiles of NMC in HIV-infected people living in Kinshasa. This is a descriptive study based on the medical records of patients who attended three clinics in Kinshasa between January 1 s t 2011 and December 31 st 2014. Only the medical records of HIV-infected people presenting the NMC were reviewed. During the 4 year-period of the study, 261 HIV-positive patients presented to the clinics for neuromeningeal syndrome, including 23 with NMC. The global prevalence of NMC was 8.8% for the three clinics. The mean age was 42.8 ± 9.5 years, with male predominance (65.2%). The main symptoms were headache (73.9%), neck stiffness (60.9%), fever (47.8%), and coma (47.8%). Biological records were as follows: median CD4 cell count was 79 cells/mm 3 ; cerebrospinal fluid (CSF) was clear for 56.5% of the cases with predominance of neutrophils in 73.9%. The outcome was fatal in 34.8% of cases. The prevalence and therapeutic outcome of NMC show that it constitutes a non-negligible OI in Kinshasa, especially in HIV-infected people at the AIDS stage. As HIV-infected people with severe immunosuppression are the most affected by NMC, active preventive measures should benefit this vulnerable category of people.

The Democratic Republic of the Congo adopted the integrase inhibitor dolutegravir (DTG) as part of its preferred first-line HIV treatment regimen in 2019. This study aimed to identify predictors of viral non-suppression among HIV-infected patients under a DTG-based regimen in the context of ongoing armed conflict since 2017 in the city of Bunia in the DRC. We conducted a cohort study of 468 patients living with HIV under DTG in all health facilities in Bunia. We calculated the proportion of participants with an HIV RNA of below 50 copies per milliliter. About three in four patients (72.8%) in this cohort had a viral load (VL) of <50 copies/mL after 6–12 months. After controlling for the effect of other covariates, the likelihood of having non-suppression remained significantly lower among the 25–34 age group and self-reported naïve patients with a baseline VL of ≥50 copies/mL. The likelihood of having non-suppression remained significantly higher among those who were at advanced stages of the disease, those with abnormal serum creatinine, those with high baseline HIV viremia over 1000 copies/mL, and the Sudanese ethnic group compared to the reference groups. This study suggests that we should better evaluate adherence, especially among adolescents and economically vulnerable populations, such as the Sudanese ethnic group in the city of Bunia. This suggests that an awareness of the potential effects of DTG and tenofovir is important for providers who take care of HIV-positive patients using antiretroviral therapy (ART), especially those with abnormal serum creatinine levels before starting treatment.

This study aims to determine the factors influencing HIV-related mortality in settings experiencing continuous armed conflict atrocities. In such settings, people living with HIV (PLHIV), and the partners of those affected may encounter specific difficulties regarding adherence to antiretroviral therapy (ART), and retention in HIV prevention, treatment, and care programs. Between July 2019 and July 2021, we conducted an observational prospective cohort study of 468 PLHIV patients treated with Dolutegravir at all the ART facilities in Bunia. The probability of death being the primary outcome, as a function of time of inclusion in the cohort, was determined using Kaplan–Meier plots. We used the log-rank test to compare survival curves and Cox proportional hazard modeling to determine mortality predictors from the baseline to 31 July 2021 (endpoint). The total number of person-months (p-m) was 3435, with a death rate of 6.70 per 1000 p-m. Compared with the 35-year-old reference group, older patients had a higher mortality risk. ART-naïve participants at the time of enrollment had a higher mortality risk than those already using ART. Patients with a high baseline viral load (≥1000 copies/mL) had a higher mortality risk compared with the reference group (adjusted hazard ratio = 6.04; 95% CI: 1.78–20.43). One-fourth of deaths in the cohort were direct victims of armed conflict, with an estimated excess death of 35.6%. Improving baseline viral load monitoring, starting ART early in individuals with high baseline viral loads, the proper tailoring of ART regimens and optimizing long-term ART, and care to manage non-AIDS-related chronic complications are recommended actions to reduce mortality. Not least, fostering women’s inclusion, justice, peace, and security in conflict zones is critical in preventing premature deaths in the general population as well as among PLHIV.