ACCEPTED CAM-HERO 2022 ABSTRACTS

Viral suppression in the era of transition to Dolutegravir-based therapy in Cameroon: children at highest risk of virological failure

Authors:
Joseph Fokam, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Alex Durand NKA, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Flore Y. Mamgue Dzukam, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Yagai Bouba, Central Technical Group, National AIDS Control Committee
Michel C. Tommo Tchouaket, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Aude C. Ka’e, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Ezechiel N.J. Semengue, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Desire Takou, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Sylvie Moudourou, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Nadine Fainguem, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Willy Pabo, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Collins A. Chenwi, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Junie F. Yimga, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Krystel M. Nnomo Zam, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Rachel Kamgaing, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Charlotte Tangimpundu, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Nelly Kamgaing, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Anne-Esther Njom-Nlend, Higher Institute of Medical Technology, Yaounde
Paul N. Koki, Mother-Child Centre, Chantal BIYA Foundation
Daniel Kesseng, Mother-Child Centre, Chantal BIYA Foundatio
Suzie N. Tetang, Essos Health Centre, National Social Welfare Centre
Etienne Kembou, World Health Organisation Afro, country office
Lifanda Ebiama Lifanda, Central Technical Group, National AIDS Control Committee
Bouba Pamen, World Health Organisation Afro, country office
Alice Ketchaji, Division of Disease, Epidemic and Pandemic Control, Ministry of Public Health
Edith S. Temgoua, Central Technical Group, National AIDS Control Committee
Serge C. Billong, Central Technical Group, National AIDS Control Committee
Anne-Cecile Z-K Bissek, Division of Health Operational Research, Ministry of Public Health
Hamsatou Hadja, Central Technical Group, National AIDS Control Committee
Edie G.E. Halle, Faculty of Health Sciences, University of Buea
Vittorio Colizzi, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Carlo-Federico Perno, Bambino Gesu Pediatric Hospital
Samuel M. Sosso, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Alexis Ndjolo, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management

Abstract ID: 93

Event: CAM-HERO 2022

Category: Clinical Science

Presenter Name: Alex Durand NKA

Presenter Preference: Oral

Keywords: : HIV, Dolutegravir at first-line therapy, Virological success

Context:

Transition to Dolutegravir (DTG)-based antiretroviral therapy (ART) may improve virological response (VR) in sub-Saharan Africa. Because VR may vary by age, understanding ART response across age-range may inform interventions on ART program. Our objective was to compare VR between children, adolescents and adults in the Cameroonian context.

Methods

A comparative study was conducted from January 2021 to May 2022 amongst ART-experienced patients received at the Chantal BIYA International Reference Centre for HIV/AIDS prevention and management in Yaoundé-Cameroon for plasma viral load (PVL) monitoring. PVL was measured on Abbott m2000RT-PCR as per manufacturer’s instructions. VR was defined as viral suppression (VL<1000 copies/mL) and viral undetectability (VL<50 copies/mL). Data were analyzed by SPSS v.20.0, with p<0.05 considered as significant.

Results

A total of 9034 patients, 72.2% female, were enrolled (8565 adults, 227 adolescents, 222 children); 1618 were on NNRTI-based, 299 on PI-based and 7117 on DTG based ART (92 children, 198 adolescents, 6824 adults). Median (IQR) duration on ART was 36 (27-39) months. Overall, VS was 89.9% (95% CI: 89.2-90.5) and 75.8% (95% CI 74.8-76.7) had achieved viral undetectability. By ART-regimen, VS on NNRTI-based, PI/r-based, and DTG-based therapy was respectively 86.5%, 60.2% and 91.9%, p<0.0001. By ART duration, VS was respectively 90.4% (M12), 87.8% (M24), 89.1% (M36) and 90.0% (≥ M48), p<0.0001. By sex, VS was 91.0% for female and 87.1% for male, p<0.0001. Most importantly, VS by age was significantly different, ranging from 65.2% in children, 74.4% in adolescents and 90.9% om adults, p<0.0001.

Conclusion

In the current ART program, nine out of ten Cameroonian patients achieve VS, with a superior efficacy of DTG-based ART (mainly adults). Nonetheless, male and pediatric populations have poorer rates of VS, especially for children below 10 years. Thus, scaling-up pediatric DTG-based ART, especially in children, would improve ART performance in similar African settings.