Virological Follow-up of Adults Living with HIV on Dolutegravir in an Approved Treatment Center in Douala (Cameroon)

Abstract

Background: Human immunodeficiency virus infection constitutes one of the greatest contemporary human pandemics, lethal in the absence of treatment. WHO 2018 recommendations have placed Dolutegravir-based treatment as first-line treatment, particularly in resource-limited countries. The aim of this work was to study the evolution of virological parameters in people undergoing treatment with this molecule.
 Methodology: This was an analytical cross-sectional study of people aged 25 and over, received since January 2015 at the Approved Treatment center of Laquintinie Hospital in Douala (Cameroon). After plasma collection and centrifugation, viral load was determined on the Abbott m2000TM platform, targeting the Pol gene. The detection threshold was greater than or equal to 40 copies/mL. Data analysis was performed using Excel and SPSS version 20 softwares.
 Results: A total of 504 people were selected, with an average age of 48±11 years and a predominance of women (70.8%). Antiretroviral treatment had been initiated at clinical stage 1 in over 80% of participants. The TDF/3TC/EFV regimen prior to initiation of Dolutegravir was used in 93.5% of cases. Mean weight after initiation of treatment was 75.9 kg. People with a viral load <40 copies/ml before starting Dolutegravir therapy accounted for 332 (65.9%) of cases, compared with 91.1% six months after starting treatment. Weight (>75kg) (95% CI, OR=1.112-2.381, p=0.012) and non-adherence (95% CI, OR=2.790-25.613, p=0.001) were considered factors associated with viral load variation.
 Conclusion: The ARV protocol comprising two nucleoside reverse transcriptase inhibitors and Dolutegravir improves virological response in people living with HIV at all clinical stages.