Chantal BIYA International Reference Centre for Research On HIV/AIDS Prevention and Management (CIRCB), Melen Road, PO BOX 3077, Yaounde, Cameroon.
Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
AIDS Res Ther. 2019 Nov 19;16(1):36. doi: 10.1186/s12981-019-0252-0.
After the launching of the « Test & Treat » strategy and the wider accessibility to viral load (VL), evaluating virological success (VS) would help in meeting the UNAIDS targets by 2020 in Cameroon.
Cross-sectional study conducted in the Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management (CIRCB), Yaoundé, Cameroon; data generated between October 2016 and August 2017 amongst adults, adolescents and children at 12, 24, 36 and ≥ 48 months on ART. VS was defined as < 1000 copies/mL of blood plasma and controlled viremia as VL < 50 copies/mL. Data were analysed by SPSS; p < 0.05 considered as significant.
1946 patients (70% female) were enrolled (1800 adults, 105 adolescents, 41 children); 1841 were on NNRTI-based and 105 on PI-based therapy; with 346 patients at M12, 270 at M24, 205 at M36 and 1125 at ≥ M48. The median (IQR) duration on was 48 months (24-48). Overall, VS was 79.4% (95% CI 77.6-81.2) and 67.1% (95% CI 64.9-69.1) had controlled viral replication. On NNRTI-based, VS was 79.9% vs. 71.4% on PIs-based, p = 0.003. By ART duration, VS was 84.1% (M12), 85.9% (M24), 75.1% (M36) and 77.2% (≥ M48), p = 0.001. By age, VS was 75.6% (children), 53.3% (adolescents) and 81.1% (adults), p < 0.001.
In this sub-population of patients receiving ART in Cameroon, about 80% might be experiencing VS, with declining performance at adolescence, with NNRTI-based regimens, and as from 36 months on ART. Thus, improving VS may require an adapted adherence support mechanism, especially for adolescents with long-term treatment in resource-limited settings.
在推出“检测即治疗”策略和更广泛地获得病毒载量（VL）之后，评估病毒学成功（VS）将有助于喀麦隆在 2020 年实现联合国艾滋病规划署的目标。
在雅温得的尚塔尔·比亚国际艾滋病毒/艾滋病预防和管理研究中心（CIRCB）进行了一项横断面研究；数据于 2016 年 10 月至 2017 年 8 月期间在接受抗逆转录病毒治疗（ART）的 12、24、36 和≥48 个月的成年人、青少年和儿童中生成。VS 定义为<1000 拷贝/ml 的血浆和 VL<50 拷贝/ml 的受控病毒血症。数据使用 SPSS 进行分析；p<0.05 被认为具有显著性。
共纳入 1946 例患者（70%为女性）（1800 例成年患者、105 例青少年患者、41 例儿童患者）；1841 例患者接受基于 NNRTI 的治疗，105 例患者接受基于 PI 的治疗；其中 346 例患者在 M12，270 例患者在 M24，205 例患者在 M36，1125 例患者在≥M48。中位（IQR）治疗时间为 48 个月（24-48）。总体而言，VS 为 79.4%（95%CI 77.6-81.2），67.1%（95%CI 64.9-69.1）患者病毒复制得到控制。基于 NNRTI 的 VS 为 79.9%，而基于 PI 的 VS 为 71.4%，p=0.003。按 ART 持续时间，VS 分别为 M12 时的 84.1%、M24 时的 85.9%、M36 时的 75.1%和 M48 时的 77.2%，p=0.001。按年龄，VS 分别为儿童时的 75.6%、青少年时的 53.3%和成年时的 81.1%，p<0.001。
在喀麦隆接受抗逆转录病毒治疗的这一亚人群中，约 80%的患者可能经历了 VS，在青春期时表现下降，采用基于 NNRTI 的方案治疗，以及从接受 ART 治疗 36 个月后。因此，提高 VS 可能需要一种适应性的依从性支持机制，特别是在资源有限的环境中对青少年进行长期治疗时。
