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

查看全文 作　　者：Henry D [1,2]Meriki;Kukwah A [1]Tufon;Mbunkah H [1]Afegenwi;Bernard A [2]Nyindem;Pascal N [1,3]Atanga;Damian N [1]Anong;Fidelis Cho-[1]Ngwa;Theresa Nkuo-[1,4]Akenji

机构地区：[1]Department of Microbiology and Parasitology,University of Buea,P.O.Box 63,Buea,Cameroon;[2]BioCollections Worldwide Inc.Regional Office,Buea,Cameroon;[3]Regional Delegation of Public Health,Southwest Region,Cameroon;[4]Faculty of Science Clinical Diagnostic Laboratory,University of Buea,Buea,Cameroon

出　　处：《Infectious Diseases of Poverty》索引2014年第3卷第1期,共11页

基　　金：BioCollections Worldwide Inc.,Miami,Florida,USA,provided financial support and performed viral load analysis;Financial assistance was also received from the University of Buea 2009-2010 Research Grant awarded to Professor Theresa Nkuo-Akenji. 摘　　要：Background:Contemporary 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.Methods:This 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.Results:The 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.Conclusion:The 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. 关键词：Immuno-haematologic PREDICTORS Virologic failure Antiretroviral therapy

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

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