Abstract
Background: Viral load is the key indicator of the effectiveness of antiretroviral treatment in HIV patients. Study aimed to determine antiretroviral treatments failure rates and associated risk factors among HIV-infected adult patients in Congo. Methods: Data from the Congolese AIDS and Epidemics Control Council were combined to create a historical cohort. Patients were followed up between 2003 to 2017. Mixed logistic regression was used to identify treatment failure associated-factors. Intercooled Stata 10 (StataCorp LP, College Station, Texas, USA) software packages was used for analysis. Results: Over 14 years of follow-up, a total of 25,500 visits for 6391 adult patients were reported. Among them, 88% i.e. 22,328 visits (for a total of 6127 patients) were visits with treatment failure. In the multivariate analysis, being aged >26 years, having primary education level, being student, others nationality, unspecifiedmarital status and being worker in informal sector were found associated with a higher risk of treatment failure. Conversely, being pensioners, receiving second line therapeutic protocols and having good adherence to treatment were found significantly associated with a lower risk of treatment failure. Conclusion: Antiretroviral treatments failure among HIV-treated patients is common in Congo. Developing treatment adherence-centered interventions with focus in patients who have low socio-economic status needed to reduced treatments failure. As treatment failure is not only determined by individual factors, psychosocial supports and availability of antiretroviral drugs needs to be taken into account.
Highlights
The human immunodeficiency virus (HIV) epidemic has affected populations around the world
As treatment failure is determined by individual factors, psychosocial supports and availability of antiretroviral drugs needs to be taken into account
In 2019, 38 million people globally were living with HIV, 1.7 million people became newly infected with HIV and 690,000 died from acquired immunodeficiency syndrome (AIDS)-related illnesses and Africa remains the continent with the highest number of cases, new infections and deaths [1]
Summary
The human immunodeficiency virus (HIV) epidemic has affected populations around the world. In Brazil, in a historical cohort study of 76,950 HIV patients aged 34 years on average, 85.2% achieved viral load suppression after 6 months of treatment [4] while in Uganda this proportion was 11% in a sample of 100,678 patients [5]. Viral load is the key indicator of the effectiveness of antiretroviral treatment in HIV patients. Study aimed to determine antiretroviral treatments failure rates and associated risk factors among HIV-infected adult patients in Congo. In the multivariate analysis, being aged >26 years, having primary education level, being student, others nationality, unspecifiedmarital status and being worker in informal sector were found associated with a higher risk of treatment failure. As treatment failure is determined by individual factors, psychosocial supports and availability of antiretroviral drugs needs to be taken into account
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