Paul Alain Tagnouokam-Ngoupo1, Ida Calixte Penda2,3, Jules Brice Tchatchueng Mbougua4, Suzie Tetang Ndiang5, Francis Yuya Septoh4, Angeladine Kenne4, Jeannine Eboumbou Ngallè3, Sorel Jakpou4, Francis Ateba Ndongo6, Josiane Warszawski7,8,9, Albert Faye10,11,12, Mathurin Cyrille Tejiokem4. 1. Service de Virologie, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé, Cameroun. 2. Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon. 3. Hôpital Laquintinie de Douala, Douala, Cameroun. 4. Service d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé, Cameroun. 5. Service de Pédiatrie, Centre Hospitalier d'Essos, Yaoundé, Cameroun. 6. Unité Pédiatrique de Jour, Centre Mère et Enfant de la Fondation Chantal Biya, Yaoundé, Cameroun. 7. Center for Research in Epidemiology and Population Health U1018, Clinical Epidemiology, INSERM, Le Kremlin-Bicetre, France. 8. Université Paris-Sud, Public Health, Le Kremlin-Bicêtre, France. 9. Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France. 10. Assistance Publique des Hôpitaux de Paris, Pédiatrie Générale, Hôpital Robert Debré, Paris, France. 11. Université Paris 7-Denis Diderot, Paris, Île-de-France, France. 12. INSERM UMR-S 1123 (ECEVE), Paris, France.
Abstract
OBJECTIVE: In the present study, we aimed to evaluate the virological failure (VF) and drug resistance among treated HIV-infected children after five years follow-up in the ANRS-Pediacam cohort in Cameroon. METHODS: From November 2007 to October 2011, HIV-infected children born to HIV-infected mothers were included in the ANRS-PEDIACAM study and followed-up for more than 5 years. Plasma viral load (VL) was measured at each visit (every three months until month 24 and every 6 months thereafter). VF was the main outcome and HIV drug resistance test was performed using the ANRS procedures and algorithm. RESULTS: Data from 155 children were analyzed. The median age at combination antiretroviral therapy (cART) initiation was 4.2 months (interquartile range (IQR): 3.2-5.8), with 103 (66.5%) children taking LPV/r-containing regimen and 51 (32.9%) children taking NVP. After five years follow-up, 63 (40.6%; CI: 32.9-48.8) children experienced VF. The median duration between cART initiation and VF was 22.1 months (IQR: 11.9-37.1) with a median VL of 4.8 log10 (IQR: 4.0-5.5). Among the 57 children with HIV drug resistance results, 40 (70.2%) had at least one drug resistance mutation. The highest resistance rates (30.4-66.1%) were obtained with Lamivudine; Efavirenz; Nevirapine and Rilpivirine. CONCLUSIONS: These results show high resistance to NNRTI and emphasize the need of VL and resistance tests for optimal follow-up of HIV-infected people especially children.
OBJECTIVE: In the present study, we aimed to evaluate the virological failure (VF) and drug resistance among treated HIV-infectedchildren after five years follow-up in the ANRS-Pediacam cohort in Cameroon. METHODS: From November 2007 to October 2011, HIV-infectedchildren born to HIV-infected mothers were included in the ANRS-PEDIACAM study and followed-up for more than 5 years. Plasma viral load (VL) was measured at each visit (every three months until month 24 and every 6 months thereafter). VF was the main outcome and HIV drug resistance test was performed using the ANRS procedures and algorithm. RESULTS: Data from 155 children were analyzed. The median age at combination antiretroviral therapy (cART) initiation was 4.2 months (interquartile range (IQR): 3.2-5.8), with 103 (66.5%) children taking LPV/r-containing regimen and 51 (32.9%) children taking NVP. After five years follow-up, 63 (40.6%; CI: 32.9-48.8) children experienced VF. The median duration between cART initiation and VF was 22.1 months (IQR: 11.9-37.1) with a median VL of 4.8 log10 (IQR: 4.0-5.5). Among the 57 children with HIV drug resistance results, 40 (70.2%) had at least one drug resistance mutation. The highest resistance rates (30.4-66.1%) were obtained with Lamivudine; Efavirenz; Nevirapine and Rilpivirine. CONCLUSIONS: These results show high resistance to NNRTI and emphasize the need of VL and resistance tests for optimal follow-up of HIV-infectedpeople especially children.
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