Background: Increasing trends of drug resistance mutations, especially in resource limited settings compromises the effectiveness of antiretroviral therapy (ART), calling for personalized treatment through genotypic resistant testing (GRT). We evaluated the treatment response of clients failing ART following GRT guided treatment change in the Center region of Cameroon.
Methodology: A Retrospective cohort study was conducted among clients failing first- and second-line regimens (i.e., non-nucleoside reverse transcriptase inhibitors (NNRTI), nucleoside reverse transcriptase inhibitors (NRTI) and protease inhibitor (PI)) from January-2017 to June-2025 at the Chantal Biya International Reference Centre (CIRCB). Clients were enrolled from five hospitals (Jamot, Military, Essos, Efoulan and Biyem-assi) using convenient exhaustive sanpling method. Demographic data, educational level, past and current ART regimens, immuno-virological history, viral load after GRT and genotypic profiles were collected from clients’ files. Data was analyzed using Epi Info v.7.2 with p<0.05 considered statistically significant.
Results: Among 248 clients eligible; 7 died, 2 stopped treatment, 15 were lost to follow-up, 155 had no follow-up data and 4 transferred out leading to 65 inclusions. Analysis revealed a female pre-dominance of 55.4% (36/65). The median duration on ART was 13years. Overall, 86.2% had unsuppressed viral load (VL) before GRT and majority failing the first-line regimen. The median CD4 and VL before GRT were 148cells/µL and 5446 copies/ml respectively. The prevailing mutations were M184IV (27.80%), Y181C (15.9%) and M36IKL (24.0%) for NRTI, NNRTI, and PI respectively. After GRT, suppressed VL was observed at 3-months (66.7%), 6-months (81.8%), 1-year (88.2%), 2-years (77.4%) and 3-years (87.1%), 4-years (73.3%), 5-years (73.3%). Neither age, gender, education, marital status, CD4 and VL before GRT, duration on ART, respected prescriptions nor genetic diversity influenced treatment response (p> 0.05).
Conclusion: The results showed sustained viral load suppression up to 5 years following genotypic guided treatment change among multidrug resistant clients in the Centre region of Cameroon.