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Mbébi Enoné PJ, Penda CI, Ngondi G, Fokam J, Ebong SB, Mekoulou Ndongo J, Essangui Same EG, Ndjengue Nson LS, Mandengue SH, Eboumbou Moukoko CE. High risk of virologic failure among HIV-infected children and adolescents routinely followed-up in Littoral region of Cameroon. PLoS One 2023; 18:e0289426. [PMID: 37561800 PMCID: PMC10414642 DOI: 10.1371/journal.pone.0289426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 07/19/2023] [Indexed: 08/12/2023] Open
Abstract
Virological response to antiretroviral therapy (ART) remains a challenge for HIV-infected children and adolescents due to non-optimization of pediatric ART for resource-limited settings. In this study, we aimed to investigate factors associated with virologic failure (VF) in HIV-infected-children and adolescents on ART in Cameroon. A prospective patient-based cohort study was conducted among HIV-infected children (0-9 years) and adolescents (10-19 years) followed-up between November 2018 and October 2019 in 38 healthcare centers located in the Littoral region of Cameroon. The 1st viral load (VL) was assessed after 6 months of ART initiation and the 2nd VL between 3 and 6 six months later in patients with VL ≥1000 copies/ml in accordance with the national algorithm using Abbott Real-Time HIV-1 Viral Load Assay. Multivariate analyses were performed to identify the determinants of higher risk of VF. Of 1,029 HIV-infected children and adolescents (393 children and 636 adolescents), 801 (77.8%) cumulatively presented with VL <1000 copies/mL within 12 months on ART. Adolescents were more likely to have VF than children (24.5% vs 18.3%, OR: 1.39; 95%CI: 1.00-1.93; p = 0.047). Patients followed-up in decentralized care units were significantly more likely to have VF compared to those attending the accredited treatment centers (26.1% vs 16.6%, OR: 1.88, 95%CI: 1.37-2.58; p<0.001). Our findings show a high rate of VL suppression (VLS, 77.8%) among HIV-infected children and adolescents, albeit lower than the established target of 90%. Being adolescent and patients followed in the decentralized care units are high risk factors for VF, thereby necessitating routine therapeutic education of patients and guardians in resource limited countries to improve VLS.
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Affiliation(s)
- Patient Juste Mbébi Enoné
- Faculty of Sciences, Department of Animal Biology and Physiology, University of Douala, Douala, Cameroon
| | - Calixte Ida Penda
- Faculty of Medicine and Pharmaceutical Sciences, Clinical Sciences Department, University of Douala, Douala, Cameroon
- Accredited HIV Care Center, Laquintinie Hospital of Douala, Douala, Cameroon
| | - Grâce Ngondi
- Faculty of Medicine and Pharmaceutical Sciences, Biological Sciences Department, University of Douala, Douala, Cameroon
- Biological Laboratory, Laquintinie Hospital of Douala, Douala, Cameroon
| | - Joseph Fokam
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Faculty of Health Sciences, Department of Medical Laboratory Science, University of Buea, Buea, Cameroon
| | - Serge Bruno Ebong
- Faculty of Sciences, Department of Animal Biology and Physiology, University of Douala, Douala, Cameroon
| | - Jerson Mekoulou Ndongo
- Faculty of Sciences, Department of Animal Biology and Physiology, University of Douala, Douala, Cameroon
| | | | | | - Samuel Honoré Mandengue
- Faculty of Sciences, Department of Animal Biology and Physiology, University of Douala, Douala, Cameroon
| | - Carole Else Eboumbou Moukoko
- Faculty of Medicine and Pharmaceutical Sciences, Biological Sciences Department, University of Douala, Douala, Cameroon
- Laboratory of Parasitology, Mycology and Virology, Postgraduate Training Unit for Health Sciences, Postgraduate School for Pure and Applied Sciences, University of Douala, Douala, Cameroon
- Centre Pasteur of Cameroon, Yaounde, Cameroon
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Dambaya B, Fokam J, Ngoufack ES, Takou D, Santoro MM, Této G, Beloumou GA, Mouafo LCM, Kamgaing N, Sosso SM, Billong SC, Njom Nlend AE, Sobze MS, Nkenfou C, Koki PN, Njiokou F, Colizzi V, Perno CF, Ndjolo A. HIV-1 Drug Resistance and Genetic Diversity among Vertically Infected Cameroonian Children and Adolescents. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2020; 000:1-9. [DOI: 10.14218/erhm.2019.00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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