Abstract
BackgroundAfter 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 methodsCross-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.Results1946 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.ConclusionsIn 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.
Highlights
Despite many decades of continuous fight, Human immunodeficiency virus (HIV) is still one of the major global health issue, having claimed more than 35 million lives so far, with the WHO African Region in particular being the most affected with 25.7 million people living with HIV in 2017 [1, 2]
As the momentum in the efforts to control the pandemic rises, the global commitment to ending HIV/AIDS epidemic was set by the United Nations (UN) Assembly for 2030 [3]
A great stride in the journey towards ending HIV/AIDS is the ambitious treatment targets set by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the 90–90–90 strategy by 2020
Summary
Despite many decades of continuous fight, Human immunodeficiency virus (HIV) is still one of the major global health issue, having claimed more than 35 million lives so far, with the WHO African Region in particular being the most affected with 25.7 million people living with HIV in 2017 [1, 2]. A great stride in the journey towards ending HIV/AIDS is the ambitious treatment targets set by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the 90–90–90 strategy by 2020. This goal stipulates that by 2020, 90% of all people living with HIV will know their HIV status; 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 90% of all people receiving antiretroviral therapy will have viral suppression [1, 4]. The 2017 report of the UNAIDS on ending AIDS progress reveals that globally, 70% of infected people know their HIV status, 77% of these are receiving combination antiretroviral therapy (cART) and 82% of treated patients have virological success (VS) [4]. Data were analysed by SPSS; p < 0.05 considered as significant
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