喀麦隆感染艾滋病毒的青少年病毒载量得到抑制：努力实现艾滋病署 95%病毒抑制目标。
Viral load suppression in HIV-infected adolescents in cameroon: towards achieving the UNAIDS 95% viral suppression target.
机构信息
Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.
UMR MIVEGEC, IRD, Université de Montpellier, CNRS, IRD, 911, avenue Agropolis, PO. Box 64501, 34394, Montpellier, Montpellier Cedex 5, France.
出版信息
BMC Pediatr. 2023 Mar 15;23(1):119. doi: 10.1186/s12887-023-03943-0.
BACKGROUND
Achieving the UNAIDS 95% sustained viral suppression (VS) rate requires considerable global efforts, particularly among adolescents living with HIV (ALHIV) who are often associated with high rates of virological failure (VF). In this study, we prospectively assessed the rate of VS, and the factors associated with VF in a cohort of adolescents followed up according to the WHO guidelines in Cameroon.
METHODS
A cross-sectional study was carried out in 2021 among adolescents (aged 10-19 years) receiving ART in the national program in Cameroon. Socio-demographic and clinical data were collected using patients' medical files and a brief interview with the participant and/or his guardian. Thereafter, a first viral load test (VL1) was performed using the ABBOTT Platform. For adolescents with VL1 > 1000 copies/ml, adherence-enhancing interventions were routinely performed each month for 3 consecutive months, after which a second viral load (VL2) was measured. Adolescents with VL2 > 1000 copies/ml were considered in VF.
RESULTS
Overall, 280 adolescents were enrolled, of whom 89.3% (250/280) acquired HIV infection via mother-to-child transmission. The median age was 16.0 (IQR: 13.0-18.0) years and the median duration on ART was 9.8 (IQR: 5.1-12.8) years. Females and males were almost equally represented, as 52.1% (146/280) were female, while 47.9% (134/280) were males (p = 0.47). The VS rate was 88.2% (CI: 83.8-91.7%) overall; 89.0% (CI: 82.0-93.1%) and 88.7% (CI: 81.2-93.0%) in females and males, respectively. Being on second or third-line ART, self-declared suboptimal adherence, and a history of past VF were independently associated with VF.
CONCLUSION
The high rate of VS we report in this study is welcome in the era of the 95/95/95 UNAIDS goals, and indicates that improving treatment outcomes in this specific and fragile population that represent adolescents in Sub-Saharan Africa is achievable.
TRIAL REGISTRATION
20/10/2020 NCT04593979 ( https://clinicaltrials.gov/ct2/show/NCT04593979 ).
背景
实现联合国艾滋病规划署 95%持续病毒抑制（VS）率需要全球做出巨大努力，尤其是在艾滋病毒感染者青少年（ALHIV）中，他们经常与病毒学失败（VF）率较高相关。在这项研究中，我们前瞻性评估了在喀麦隆根据世卫组织指南接受治疗的青少年队列中的 VS 率，以及与 VF 相关的因素。
方法
2021 年，我们在喀麦隆国家方案中对接受抗逆转录病毒治疗的青少年（年龄 10-19 岁）进行了一项横断面研究。使用患者的病历和对参与者和/或其监护人的简短访谈收集了社会人口统计学和临床数据。此后，使用 ABBOTT 平台进行了第一次病毒载量测试（VL1）。对于 VL1>1000 拷贝/ml 的青少年，常规每月进行增强依从性干预，连续 3 个月，然后测量第二次病毒载量（VL2）。VL2>1000 拷贝/ml 的青少年被认为存在 VF。
结果
总体而言，共纳入 280 名青少年，其中 89.3%（250/280）通过母婴传播感染 HIV。中位年龄为 16.0（IQR：13.0-18.0）岁，ART 治疗中位时间为 9.8（IQR：5.1-12.8）年。女性和男性几乎各占一半，分别为 52.1%（146/280）为女性，47.9%（134/280）为男性（p=0.47）。总体 VS 率为 88.2%（CI：83.8-91.7%）；女性为 89.0%（CI：82.0-93.1%），男性为 88.7%（CI：81.2-93.0%）。接受二线或三线抗逆转录病毒治疗、自我报告的不依从性和过去 VF 史与 VF 独立相关。
结论
在联合国艾滋病规划署 95/95/95 目标时代，我们报告的高 VS 率令人欢迎，这表明在撒哈拉以南非洲代表青少年的这一特定和脆弱人群中，改善治疗结果是可行的。
试验注册
2020 年 10 月 20 日 NCT04593979（https://clinicaltrials.gov/ct2/show/NCT04593979）。
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