Fokam Joseph, Billong Serge Clotaire, Jogue Franck, Moyo Tetang Ndiang Suzie, Nga Motaze Annie Carole, Paul Koki Ndombo, Njom Nlend Anne Esther
Virology Laboratory, Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management, Yaoundé, Cameroon.
Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
PLoS One. 2017 Nov 7;12(11):e0187566. doi: 10.1371/journal.pone.0187566. eCollection 2017.
Limited studies have reported the outcomes of lifelong antiretroviral therapy (ART) amongst adolescents living with HIV (ALWHIV) in resource-limited settings (RLS), thus classifying this population as underserved. We therefore aimed to ascertain the immunological and virological responses, and associated factors amongst Cameroonian ALWHIV.
A cross-sectional and observational study was conducted from January through May 2016 at the National Social Insurance Fund Health Centre in Yaoundé-Cameroon. Immunological and virological responses were evaluated using CD4 cell count and viral load respectively, with viral suppression (VS) defined as <50 copies/ml. Adherence was evaluated using self-reported missing doses during the past 14 days. Data were analyzed using R v.3.3.0, with p<0.05 considered statistically significant.
Of the 145 ALWHIV on ART enrolled in the study, 52% were female, median age [interquartile (IQR)] was 13 [11-16] years, median [IQR] time-on-ART was 7 [5-10] years, 48% were orphans, 92% were on first-line ART and 36% were adherent to ART. Following ART response, 79% (114/145) had CD4 ≥500/mm3, 71.0% (103/145) were on VS of whom 52.4% (76/145) had a sustained VS. Duration of ART was associated with immune restoration (Odd Ratio 3.73 [1.26-12.21]) but not with virological response. Risks of poor adherence were greater in orphans of both parents (p = 0.078).
In this urban setting of Cameroon, ALWHIV receiving ART show favorable immunological and virological response in a medium run. For long-term ART success, implementing a close monitoring of adherence and risks of viral rebound would be highly relevant, especially for orphans of both parents.
在资源有限的环境中，关于感染艾滋病毒青少年（ALWHIV）接受终身抗逆转录病毒疗法（ART）的研究报告有限，因此该人群被归类为服务不足。因此，我们旨在确定喀麦隆感染艾滋病毒青少年的免疫和病毒学反应以及相关因素。
2016年1月至5月在喀麦隆雅温得的国家社会保险基金健康中心进行了一项横断面观察性研究。分别使用CD4细胞计数和病毒载量评估免疫和病毒学反应，病毒抑制（VS）定义为<50拷贝/毫升。使用过去14天内自我报告的漏服剂量评估依从性。使用R v.3.3.0分析数据，p<0.05被认为具有统计学意义。
在该研究中登记接受抗逆转录病毒治疗的145名感染艾滋病毒青少年中，52%为女性，中位年龄[四分位间距（IQR）]为13[11-16]岁，抗逆转录病毒治疗的中位[IQR]时间为7[5-10]年，48%为孤儿，92%接受一线抗逆转录病毒治疗，36%坚持抗逆转录病毒治疗。抗逆转录病毒治疗后，79%（114/145）的CD4≥500/mm3，71.0%（103/145）实现了病毒抑制，其中52.4%（76/145）实现了持续病毒抑制。抗逆转录病毒治疗的持续时间与免疫恢复相关（优势比3.73[1.26-12.21]），但与病毒学反应无关。双亲孤儿的依从性差风险更大（p = 0.078）。
在喀麦隆的这个城市环境中，接受抗逆转录病毒治疗的感染艾滋病毒青少年在中期显示出良好的免疫和病毒学反应。为了长期的抗逆转录病毒治疗成功，密切监测依从性和病毒反弹风险将非常重要，尤其是对于双亲孤儿。
