Dagba Gbessin Edwige Hermione, Gomgnimbou Michel Kiréopori, Keke René Kpemahouton, Sina Haziz, Afangnihoun Aldric, Bachabi Moussa, Ouedraogo Abdoul-Salam, Baba-Moussa Lamine
NAZI BONI University, Bobo-Dioulasso, Burkina Faso.
National Reference Laboratory of Health Program Fighting Against AIDS in Benin (LNR/PSLS), Health Ministry of Benin, Akpakpa, Benin.
BMC Infect Dis. 2025 Mar 27;25(1):427. doi: 10.1186/s12879-025-10830-9.
Monitoring the effectiveness of antiretroviral treatment by measuring viral load is a strong recommendation from the WHO following the intensification of this therapy, which, if well managed, improves patients' quality of life. In children, treatment options are limited and virological non-suppression is high. Virological suppression among children living with HIV who were followed at care facilities during the SARS-CoV-2 pandemic is poorly documented in countries with intermediate resources, such as Benin. Methods A longitudinal study was carried out from November 20, 2020, among children under 15 years of age who had been receiving ART for at least six months in five healthcare facilities. TCD4 lymphocytes (LTCD4) count was performed using the CyFlow counter II (from Partec laboratories). Viral load was performed using the Abbott RealTime HIV-1 assay (Abbott Molecular, Inc.). The linear range of 40-10.000.000 copies/ml and a detection limit of 40 copies/ml were defined by the manufacturers. Virological success was assessed as a suppressed viral load (VL < 3log). For children whose VL ≥ 3log, WHO 2016 recommendations were applied and therapeutic education sessions were offered for 3 months, after which VL was measured. Children whose (VL and VL) ≥ 3log were considered not suppressed. Results The mean age of 305 children enrolled was 110 (SD 41.25) months, with a predominance of girls at 52.8% (161/305). The median LTCD4 at study starting was 814 [IQR 544-1118] cells/µl. Overall, 73.11% (223/305) of children achieved virological success at the first viral load measurement, compared to 79.63% (219/275) at the second (03 months after the first). Between the two measurements, 9.83% (30/305) of children did not keep their medical appointments due to SARS-CoV-2 pandemic restrictions. Also, 20.73% (17/82) of non-suppressed children at VL went undetectable. Among the 17.1% (47/275) of unsuppressed children, 10.64% (5/47) were on integrase strand transfer inhibitors as DTG (Dolutegravir). Conclusion This study, conducted in children on ART during the SARS-CoV-2 pandemic, highlighted a high rate of retention in care and viral suppression. However, there are challenges in achieving the UNAIDS third 95 to ensure sustainable viral suppression in children.
随着抗逆转录病毒疗法的强化，通过测量病毒载量来监测其有效性是世界卫生组织的一项强烈建议，若管理得当，该疗法可改善患者生活质量。在儿童中，治疗选择有限且病毒学未抑制率很高。在资源中等的国家，如贝宁，关于在新冠疫情期间在护理机构接受随访的感染艾滋病毒儿童的病毒学抑制情况记录不足。方法 2020年11月20日起在五个医疗机构对至少接受六个月抗逆转录病毒治疗的15岁以下儿童开展了一项纵向研究。使用赛弗洛计数器II（帕泰克实验室）进行总CD4淋巴细胞（TCD4）计数。使用雅培实时HIV-1检测法（雅培分子公司）检测病毒载量。制造商规定线性范围为40 - 10000000拷贝/毫升，检测限为40拷贝/毫升。病毒学成功定义为病毒载量被抑制（VL＜3log）。对于病毒载量≥3log的儿童，应用世界卫生组织2016年的建议并提供为期3个月的治疗教育课程，之后测量病毒载量。病毒载量（VL）≥3log的儿童被视为未被抑制。结果 纳入的305名儿童的平均年龄为110（标准差41.25）个月，女孩占比52.8%（161/305）。研究开始时TCD4中位数为814[四分位间距544 - 1118]个细胞/微升。总体而言，73.11%（223/305）的儿童在首次病毒载量测量时实现了病毒学成功，第二次测量（首次测量后3个月）时这一比例为79.63%（219/275）。在两次测量之间，9.83%（30/305）的儿童因新冠疫情限制未按时就诊。此外，病毒载量未被抑制的儿童中有20.73%（17/82）检测不到病毒。在17.1%（47/275）未被抑制的儿童中，10.64%（5/47）正在使用整合酶链转移抑制剂多替拉韦（DTG）。结论 这项在新冠疫情期间对接受抗逆转录病毒治疗的儿童开展的研究突出了较高的护理留存率和病毒抑制率。然而，要实现联合国艾滋病规划署的第三个95目标以确保儿童持续的病毒抑制仍存在挑战。
