Immuno-haematologic and virologic responses and predictors of virologic failure in HIV-1 infected adults on first-line antiretroviral therapy in Cameroon

Abstract

BackgroundContemporary data on the immunologic, haematologic and virologic responses and predictors of virologic failure after initiation of free antiretroviral treatment in Cameroon are needed to evaluate the current treatment-monitoring algorithm and to complement efforts to scale-up and improve on the management of HIV infections.MethodsThis was a cross-sectional study conducted between October 2010 and June 2012. A total of 951 participants aged 18–74 years were recruited from selected approved HIV treatment centres of the Northwest and Southwest regions. This comprised 247 males and 704 females. Demographic, self-reported risk behaviours and socioeconomic data were obtained using a structured questionnaire. Full blood and CD4 + T-cell counts were done using standard automated techniques. Determination of viral load (VL) was done using Abbott RealTime HIV-1 m2000™ system. Data was analysed using SPSS version 17. The statistical significance level was P < 0.05.ResultsThe median duration of antiretroviral therapy (ART) was 24 months. The population mean CD4 + T-cell count was 255.3 cells/μL [95% CI, 236.8 – 273.9]. Overall, 45.9%, 43.8% and 10.2% of the participants had CD4 + T-cell counts of < 200 cells/μL, 200–499 cells/μL and > 500 cells/μL respectively. Anaemia was present in 26.2% of the participants with 62.3%, 25.7% and 12% described as mild, moderate and severe anaemia respectively. Virologic failure occurred in 23.2% of the participants with 12.3% having VL > 10,000 RNA copies/mL. Meanwhile 76.8% of patients attained adequate viral suppression with 40.8% having undetectable viral load. The age group 18–29 years (p = 0.024), co-infection with tuberculosis (p = 0.014), anaemia (p = 0.028) and distance from the treatment centre (p = 0.011) independently predicted virologic failure.ConclusionThe majority of the participants achieved adequate viral suppression after ≥ 6 months of ART. Despite these favourable immuno-haematologic and virologic outcomes, the National AIDS Control Program should step-up efforts to improve on antiretroviral drug distribution, as well as proper assessment and management of anaemia, foster early diagnosis and treatment of tuberculosis and enhance treatment adherence counselling especially in younger patients.

HIV/AIDS Treatment Failure and its Determinant Factors among First Line HAART Patients at Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

“…This finding was comparable with study conducted in Uganda 9.9% [23] and Gondar 4.1% [16]. However; when compared with other studies, for instance a study conducted in Cameron (23.2%) [24] and costal Kenya (24%) [18] our finding was very low. The probable variation might be due to study design difference and sample size.…”

“…In treatment failure, viral load criteria identified failure significantly earlier (median, 47.0 months; p<0.001) than did CD4 count criteria (median, 63.0 months).This study indicated that median time was higher when compared with the study conducted in South Africa 15 months [25], 24 months from Cameroon [24], 24 months from Gondar, Ethiopia [26] and 19.7 months from Addis Ababa, Ethiopia [27].…”

Surveillance and response systems for elimination of tropical diseases: summary of a thematic series in Infectious Diseases of Poverty

“…The 13 original research articles [10,[19][20][21][22][23][24][25][26][27][28][29][30] cover a broad array of topics along the entire value chain from innovation to application. The development and validation of mathematical models are discussed, social media communications arising from notifications of disease outbreaks are introduced and in vitro gene silencing (e.g.…”

“…Contemporary data on immunological, haematological and viral responses and predictors of reported therapeutic failure after initiation of free antiretroviral treatment in Cameroon were collected to evaluate existing treatmentmonitoring algorithms and to complement efforts to scale-up and improve the management of HIV/AIDS [20].…”

Effectiveness and safety of traditional Chinese medicine in treating acquired immune deficiency syndrome: 2004–2014

“…Mortality and morbidity have been reduced since combination antiretroviral therapy (cART) was introduced in 1996 [5]; cART has led to a notable increase in survival and quality of life (QOL) and has substantially improved the health status of HIV infected patients [6, 7]. …”