Authors:
Yagai Bouba, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon;
Ebiama Lifanda, Central Technical Group, National AIDS Control Committee (NACC), Yaounde, Cameroon
Rose Armelle Ada, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Dominik Tameza Guebiapsi, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Joseph Fokam, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management
Suzane Essamba, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Nancy Barbara Mbengono1, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Audrey Djomo, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Edith Michele Temgoua, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Caroline Medouane, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Sabine Atsinkou, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Justin Leonel Mvogo, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Jocelyne Carmen Babodo, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Roger Martin Onana, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Jean de Dieu Anoubissi, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Alice Ketchaji, Division of Disease, Epidemic and Pandemic Control, Ministry of Public Health, Yaoundé, Cameroon
Alex Durand Nka, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management, Yaoundé, Cameroon
Marie Amougou, Centre De Recherche sur Les Maladies Emergentes Et Re-Emergentes (CREMER), Yaoundé, Cameroon
Julius Nwobegahay, Centre for Research and Military Health (CRESAR), Yaoundé, Cameroon
Comfort Vuchas, The Bamenda Center for Health Promotion and Research, Bamenda, Cameroon
Anna Nya Nsimen, The Bamenda Center for Health Promotion and Research, Bamenda, Cameroon
Bertrand Eyoum Bille, Retrovirology Laboratory, Laquintinie Hospital, Douala, Cameroon
Sanda Gatchuessi kenmegne, Fondation Sociale Suisse, Pette Hospital, Pette, Cameroon
Francis Ateba, Mother-Child Centre, Chantal BIYA Foundation, Yaoundé, Cameroon
Daniel Kesseng, Mother-Child Centre, Chantal BIYA Foundation, Yaoundé, Cameroon
Suzie N. Tetang, Essos Health CentreNational Social Welfare Centre, Yaounde, Cameroon
Maria Mercedes Santoro, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
Francesca Ceccherini-Silberstein, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
Joelle Bouba Pamen, Division of Disease, Epidemic and Pandemic Control, Ministry of Public Health, Yaoundé, Cameroon
Paul N. Koki, Mother-Child Centre, Chantal BIYA Foundation, Yaoundé, Cameroon
Alexis Ndjolo, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management, Yaoundé, Cameroon
Carlo-Federico Perno, Bambino Gesu Pediatric Hospital, Rome, Italy
Serge Clotaire Billong, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Hamsatou Hadja Cherif, Central Technical Group, National AIDS Control Committee (NACC), Yaoundé, Cameroon
Anne-Cecile Z-K Bissek, Division of Health Operational Research, Ministry of Public Health, Yaoundé, Cameroon
Background
The advent of novel antiretroviral therapies (ART) has led to a high-level of viral suppression (VS). However, achieving VS is still challenging in some settings/populations, thus calling for analysis in vulnerable populations such as paediatrics. We evaluated the rate of virological response in a large and nationally representative sample of ART-experienced children, adolescents and young-adults in Cameroon.
Methods:
A cross-sectional study was conducted using the national database on viral-load (VL) performed between July-2021 and June-2022 among children (<10 years), adolescents (10-19 years) and young-adults (20-24 years). Socio-demographic and treatment data were collected and analysed according to VL result. Non-VS was defined as VL≥1000 copies/mL, predictors of non-VS were investigated.
Results:
Overall, 7382 individuals (children [19.0%], adolescents [29.1%], young-adults [51.9%]), mainly females (72.5%) were analysed. Regarding ART-regimen, 77.7% were on DTG-based ART (54.8%, 81.9% and 83.7% respectively for children, adolescents and young-adults); 74.5% were on TDF+3TC+DTG, followed by 11.1% on TDF+3TC+EFV. Overall VS [95% CI] was 82.3% [81.5-83.2]. Non-VS significantly increased with decreasing age (<5, 5-9, 10-14, 15-19 and 20-24 years: 29.4, 24.1%, 20.5%, 18.1% and 13.7%, respectively, p<0.001). A higher rate of nVS was observed in males versus females (21.5% vs. 16.2%, p<0.001). According to regimen, rate of non-VS was 15.3% (TDF+3TC+DTG), 17.6% (TDF/3TC+EFV), and 34.2% (ABC+3TC+ATV/LPV), p<0.001. Of note, non-VS on DTG-based regimen was 15.6% versus 32.0% in LPV/r or ATV/r regimens. After adjusting for age, sex, regimen, ART-duration, NRTI-backbone and anchor-drug, predictors of non-VS were: younger age (aOR [95% CI]: 1.148 [1.090-1.209]), males (aOR [95% CI]: 1.160 [1.013-1.328]) and non-DTG-based ART (aOR [95% CI]: 0.818 [0.732-0.914]).
Conclusion:
Overall, VS remains suboptimal (82%); poor VS was predicted by younger age, sex and non-DTG containing regimens. This underscores the need to rapidly scale-up DTG-based regimen.
