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Assogba YP, Adechina AP, Tchiakpe E, Nouatin OP, Kèkè RK, Bachabi M, Bankole HS, Yessoufou A. Advanced in immunological monitoring of HIV infection: profile of immune cells and cytokines in people living with HIV-1 in Benin. BMC Immunol 2024; 25:22. [PMID: 38643073 PMCID: PMC11031881 DOI: 10.1186/s12865-024-00615-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 04/03/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Immune cells and cytokines have been linked to viremia dynamic and immune status during HIV infection. They may serve as useful biomarkers in the monitoring of people living with HIV-1 (PLHIV-1). The present work was aimed to assess whether cytokines and immune cell profiles may help in the therapeutic follow-up of PLHIV-1. METHODS Forty PLHIV-1 in treatment success (PLHIV-1s) and fifty PLHIV-1 in treatment failure (PLHIV-1f) followed at the University Hospital of Abomey-Calavi/Sô-Ava in Benin were enrolled. Twenty healthy persons were also recruited as control group. Circulating cytokines and immune cells were quantified respectively by ELISA and flow cytometry. RESULTS PLHIV-1 exhibited low proportions of CD4 + T cells, NK, NKT, granulocytes, classical and non-classical monocytes, and high proportions of CD8 + T cells, particularly in the PLHIV-1f group, compared to control subjects. Eosinophils, neutrophils and B cell frequencies did not change between the study groups. Circulating IFN-γ decreased whereas IL-4 significantly increased in PLHIV-1s compared to PLHIV-1f and control subjects even though the HIV infection in PLHIV-1s downregulated the high Th1 phenotype observed in control subjects. However, Th1/Th2 ratio remained biased to a Th1 phenotype in PLHIV-1f, suggesting that high viral load may have maintained a potential pro-inflammatory status in these patients. Data on inflammatory cytokines showed that IL-6 and TNF-α concentrations were significantly higher in PLHIV-1s and PLHIV-1f groups than in control subjects. Significant high levels of IL-5 and IL-7 were observed in PLHIV-1f compared to controls whereas PLHIV-1s presented only a high level of IL-5. No change was observed in IL-13 levels between the study groups. CONCLUSION Our study shows that, in addition to CD4/CD8 T cell ratio, NK and NKT cells along with IL-6, TNF-α, IL-5 and IL-7 cytokines could serve as valuable immunological biomarkers in the therapeutic monitoring of PLHIV-1 although a larger number of patients would be necessary to confirm these results.
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Affiliation(s)
- Yaou Pierrot Assogba
- Laboratory of Cell Biology, Physiology and Immunology, Department of Biochemistry and Cellular Biology, Faculty of Sciences and Technology (FAST), Institute of Applied Biomedical Sciences (ISBA), University of Abomey-Calavi (UAC), Cotonou, 01 BP 526, Benin
| | - Adefounke Prudencia Adechina
- Laboratory of Cell Biology, Physiology and Immunology, Department of Biochemistry and Cellular Biology, Faculty of Sciences and Technology (FAST), Institute of Applied Biomedical Sciences (ISBA), University of Abomey-Calavi (UAC), Cotonou, 01 BP 526, Benin
| | - Edmond Tchiakpe
- Laboratory of Cell Biology, Physiology and Immunology, Department of Biochemistry and Cellular Biology, Faculty of Sciences and Technology (FAST), Institute of Applied Biomedical Sciences (ISBA), University of Abomey-Calavi (UAC), Cotonou, 01 BP 526, Benin
- National Reference Laboratory of Health Program Fighting Against AIDS in Benin (LNR/PSLS), Ministry of Health, Cotonou, BP 1258, Benin
| | | | - René K Kèkè
- National Reference Laboratory of Health Program Fighting Against AIDS in Benin (LNR/PSLS), Ministry of Health, Cotonou, BP 1258, Benin
| | - Moussa Bachabi
- National Reference Laboratory of Health Program Fighting Against AIDS in Benin (LNR/PSLS), Ministry of Health, Cotonou, BP 1258, Benin
| | - Honoré Sourou Bankole
- The Laboratory of Research and Applied Biology (LARBA), Unité de Recherche en Microbiologie Appliquée et Pharmacologie des Substances Naturelles, EPAC, Université d'Abomey-Calavi (UAC), Cotonou, 01 BP 2009, Bénin
| | - Akadiri Yessoufou
- Laboratory of Cell Biology, Physiology and Immunology, Department of Biochemistry and Cellular Biology, Faculty of Sciences and Technology (FAST), Institute of Applied Biomedical Sciences (ISBA), University of Abomey-Calavi (UAC), Cotonou, 01 BP 526, Benin.
- Centre de Recherche pour la lutte contre les Maladies Infectieuses Tropicales (CReMIT), Université d'Abomey-Calavi (UAC), Cotonou, 01 BP 526, Benin.
- Institute of Applied Biomedical Sciences (ISBA), Ministry of High Education and Scientific Research, Cotonou, 01 BP 918, Bénin.
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Mboup A, Diabaté S, Béhanzin L, Guédou FA, Zannou DM, Kêkê RK, Bachabi M, Gangbo F, Marzinke MA, Hendrix C, Gagnon MP, Alary M. Determinants of HIV Preexposure Prophylaxis Adherence Among Female Sex Workers in a Demonstration Study in Cotonou, Benin: A Study of Behavioral and Demographic Factors. Sex Transm Dis 2021; 48:565-571. [PMID: 33448731 PMCID: PMC8284381 DOI: 10.1097/olq.0000000000001373] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 01/05/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND HIV preexposure prophylaxis (PrEP) efficacy is closely linked to adherence, and factors associated with PrEP adherence are not well understood and may differ across populations. As PrEP demonstration projects and implementation are ongoing, it is essential to understand factors associated with adherence to oral PrEP to design effective adherence interventions and maximize the public health impact of PrEP. We thus aimed to assess demographic and behavioral factors associated with optimal PrEP adherence (100%) among female sex workers (FSWs) participating in a demonstration project in Cotonou, Benin. METHODS Female sex workers were provided with daily Truvada and followed quarterly for 1 to 2 years. Sociodemographics, partners, and behaviors were collected through face-to-face questionnaires. Another questionnaire based on sexual the theory of planned behavior and the theory of interpersonal behavior was also administered. Generalized estimating equations were used to identify factors associated with optimal daily adherence. RESULTS At baseline, 255 FSWs were followed up. One-year increase in age of FSWs was associated with a 3% increase in optimal adherence (prevalence ratio, 1.03; 95% confidence interval, 1.01-1.05; P for trend = 0.0003), and optimal adherence decreased by 31% for every 6 months of follow-up (prevalence ratio, 0.69; 95% confidence interval, 0.59-0.79; P for trend < 0.0001). For the participants who have completed the behavioral questionnaires, high intention to adhere to the treatment was also a predictor of optimal adherence. CONCLUSIONS Efforts should be geared toward FSWs intending to use PrEP to help them reach adequate adherence levels for effective HIV protection.
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Affiliation(s)
- Aminata Mboup
- From the Département de médecine sociale et préventive, Université Laval
- Centre de recherche du CHU de Québec–Université Laval, Québec, Canada
| | - Souleymane Diabaté
- From the Département de médecine sociale et préventive, Université Laval
- Centre de recherche du CHU de Québec–Université Laval, Québec, Canada
- Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - Luc Béhanzin
- From the Département de médecine sociale et préventive, Université Laval
- Dispensaire IST, Centre de Santé de Cotonou 1, Cotonou
- École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou
| | - Fernand Aimé Guédou
- From the Département de médecine sociale et préventive, Université Laval
- Dispensaire IST, Centre de Santé de Cotonou 1, Cotonou
| | - Djimon Marcel Zannou
- Faculté des sciences de la santé, Université d'Abomey-Calavi
- Centre national hospitalier universitaire HMK
| | - René K. Kêkê
- Programme Santé de Lutte contre le Sida (PSLS), Cotonou, Bénin
| | - Moussa Bachabi
- Programme Santé de Lutte contre le Sida (PSLS), Cotonou, Bénin
| | - Flore Gangbo
- Faculté des sciences de la santé, Université d'Abomey-Calavi
- Centre national hospitalier universitaire HMK
- Programme Santé de Lutte contre le Sida (PSLS), Cotonou, Bénin
| | | | - Craig Hendrix
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Marie-Pierre Gagnon
- Centre de recherche du CHU de Québec–Université Laval, Québec, Canada
- Faculté des sciences infirmières, Université Laval, Québec, Canada
| | - Michel Alary
- From the Département de médecine sociale et préventive, Université Laval
- Centre de recherche du CHU de Québec–Université Laval, Québec, Canada
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Tchiakpe E, Keke RK, Vidal N, Bachabi M, Gangbo FA, Diop‑Ndiaye H, Toure‑Kane C, Yessoufou A. Contribution of the classical polymerase chain reaction in the diagnosis of a HIV-1 infected patient in Benin: a case report. AIDS Res Ther 2021; 18:18. [PMID: 33882959 PMCID: PMC8059016 DOI: 10.1186/s12981-021-00342-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 04/08/2021] [Indexed: 11/26/2022] Open
Abstract
Background First ambitious target by 2020 of UNAIDS is that 90% of people living with HIV know their HIV status. In people older than 18 months of age, serological confirmation test is recommended to confirm HIV infection. Case presentation Here we report the case of a patient tested positive with HIV-1, ELISA, Murex® Ag⁄Ab Combination assay (OD450 = 0.802 and cutoff-OD = 0.279) and negative by using FIRST RESPONSE HIV1-2.O CARD TEST (version 2.0) RAPID HIV CARD TEST. Viral load performed with Cobas® TaqMan® 96/Cobas® Ampliprep® was 6.49log10. The virus could be sequenced in partial gag and pol genes and belonged to CRF02_AG clade. Conclusion Conventional PCR is a complementary method for the diagnosis of inconclusive HIV-1 serologies by antibodies.
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Geidelberg L, Mitchell KM, Alary M, Mboup A, Béhanzin L, Guédou F, Geraldo N, Goma-Matsétsé E, Giguère K, Aza-Gnandji M, Kessou L, Diallo M, Kêkê RK, Bachabi M, Dramane K, Lafrance C, Affolabi D, Diabaté S, Gagnon MP, Zannou DM, Gangbo F, Silhol R, Cianci F, Vickerman P, Boily MC. Mathematical Model Impact Analysis of a Real-Life Pre-exposure Prophylaxis and Treatment-As-Prevention Study Among Female Sex Workers in Cotonou, Benin. J Acquir Immune Defic Syndr 2021; 86:e28-e42. [PMID: 33105397 PMCID: PMC7803451 DOI: 10.1097/qai.0000000000002535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/28/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Daily pre-exposure prophylaxis (PrEP) and treatment-as-prevention (TasP) reduce HIV acquisition and transmission risk, respectively. A demonstration study (2015-2017) assessed TasP and PrEP feasibility among female sex workers (FSW) in Cotonou, Benin. SETTING Cotonou, Benin. METHODS We developed a compartmental HIV transmission model featuring PrEP and antiretroviral therapy (ART) among the high-risk (FSW and clients) and low-risk populations, calibrated to historical epidemiological and demonstration study data, reflecting observed lower PrEP uptake, adherence and retention compared with TasP. We estimated the population-level impact of the 2-year study and several 20-year intervention scenarios, varying coverage and adherence independently and together. We report the percentage [median, 2.5th-97.5th percentile uncertainty interval (95% UI)] of HIV infections prevented comparing the intervention and counterfactual (2017 coverages: 0% PrEP and 49% ART) scenarios. RESULTS The 2-year study (2017 coverages: 9% PrEP and 83% ART) prevented an estimated 8% (95% UI 6-12) and 6% (3-10) infections among FSW over 2 and 20 years, respectively, compared with 7% (3-11) and 5% (2-9) overall. The PrEP and TasP arms prevented 0.4% (0.2-0.8) and 4.6% (2.2-8.7) infections overall over 20 years, respectively. Twenty-year PrEP and TasP scale-ups (2035 coverages: 47% PrEP and 88% ART) prevented 21% (17-26) and 17% (10-27) infections among FSW, respectively, and 5% (3-10) and 17% (10-27) overall. Compared with TasP scale-up alone, PrEP and TasP combined scale-up prevented 1.9× and 1.2× more infections among FSW and overall, respectively. CONCLUSIONS The demonstration study impact was modest, and mostly from TasP. Increasing PrEP adherence and coverage improves impact substantially among FSW, but little overall. We recommend TasP in prevention packages.
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Affiliation(s)
- Lily Geidelberg
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Kate M. Mitchell
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Michel Alary
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Quebec, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec–Université Laval, Québec, Quebec, Canada
- Institut National de Santé Publique du Québec, Québec, Quebec, Canada
| | - Aminata Mboup
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Quebec, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec–Université Laval, Québec, Quebec, Canada
| | - Luc Béhanzin
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec–Université Laval, Québec, Quebec, Canada
- Dispensaire IST, Centre de Santé Communal de Cotonou 1, Cotonou, Bénin
- École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou, Parakou, Bénin
| | - Fernand Guédou
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec–Université Laval, Québec, Quebec, Canada
- Dispensaire IST, Centre de Santé Communal de Cotonou 1, Cotonou, Bénin
| | - Nassirou Geraldo
- Dispensaire IST, Centre de Santé Communal de Cotonou 1, Cotonou, Bénin
| | | | - Katia Giguère
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Quebec, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec–Université Laval, Québec, Quebec, Canada
| | | | - Léon Kessou
- Service de Consultance et Expertise Nouvelle en Afrique (SCEN AFRIK), Cotonou, Bénin
| | - Mamadou Diallo
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Quebec, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec–Université Laval, Québec, Quebec, Canada
| | - René K. Kêkê
- Programme Santé de Lutte Contre le Sida (PSLS), Cotonou, Bénin
| | - Moussa Bachabi
- Programme Santé de Lutte Contre le Sida (PSLS), Cotonou, Bénin
| | - Kania Dramane
- École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou, Parakou, Bénin
| | - Christian Lafrance
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec–Université Laval, Québec, Quebec, Canada
| | - Dissou Affolabi
- Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Bénin
- Centre National Hospitalier Universitaire HMK de Cotonou, Cotonou, Bénin
| | - Souleymane Diabaté
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Quebec, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec–Université Laval, Québec, Quebec, Canada
- Université Alassane Ouattara, Bouake, Côte d'Ivoire
| | - Marie-Pierre Gagnon
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec–Université Laval, Québec, Quebec, Canada
- Faculté des Sciences Infirmières, Université Laval, Québec, Québec, Canada
| | - Djimon M. Zannou
- Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Bénin
- Centre National Hospitalier Universitaire HMK de Cotonou, Cotonou, Bénin
| | - Flore Gangbo
- Programme Santé de Lutte Contre le Sida (PSLS), Cotonou, Bénin
- Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Bénin
- Centre National Hospitalier Universitaire HMK de Cotonou, Cotonou, Bénin
| | - Romain Silhol
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Fiona Cianci
- Health Protection Surveillance Center, Dublin, Ireland; and
- Population Health Sciences, University of Bristol, Bristol, United Kindom
| | - Peter Vickerman
- Population Health Sciences, University of Bristol, Bristol, United Kindom
| | - Marie-Claude Boily
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec–Université Laval, Québec, Quebec, Canada
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Tchiakpe E, Keke RK, Vidal N, Ahoussinou C, Sekpe O, Dagba HG, Gbaguidi E, Tonoukouen C, Afangnihoun A, Bachabi M, Gangbo FA, Diop-Ndiaye H, Toure-Kane C. Moderate rate of transmitted resistance mutations to antiretrovirals and genetic diversity in newly HIV-1 patients diagnosed in Benin. BMC Res Notes 2020; 13:314. [PMID: 32616057 PMCID: PMC7330984 DOI: 10.1186/s13104-020-05151-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/24/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Seventeen years after the start of the IBAARV (Beninese initiative for access to antiretrovirals), transmitted drug resistance mutations in ARV-naïve patients and HIV-1 genetic diversity were investigated in Benin. RESULTS Drug resistance mutations were detected in (27/248; 10.9%) according to the WHO SDRM 2009 list, with a predominance of mutations directed against NNRTIs drugs (24/248; 10%). Phylogenetic and recombination analyses showed a predominance of CRF02_AG strains (165/248; 66.5%) and a high genetic diversity with five other variants and 39 URFs (15.7%) which contained portions of strains that co-circulate in Benin. Eight recent transmission chains revealed active ongoing transmission of HIV-1 strains among ARV-naïve patients. Our study showed a moderate primary drug resistance mutations rate and also provided recent data on the HIV-1 variants that circulate in Benin. Regular monitoring of primary drug resistance is required to adapt HIV-1 treatment strategies and adoption of new WHO recommendations in Benin.
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Affiliation(s)
- Edmond Tchiakpe
- National Reference Laboratory of Health Program Fighting Against AIDS in Benin (LNR/PSLS), Health Ministry of Benin, BP 1258, Cotonou, Benin
- Laboratory of Cell Biology and Physiology, Department of Biochemistry and Cellular Biology, Faculty of Sciences and Technology (FAST) and Institute of Applied Biomedical Sciences (ISBA), University of Abomey-Calavi, 01, BP 918 Cotonou, Benin
| | - Rene K. Keke
- National Reference Laboratory of Health Program Fighting Against AIDS in Benin (LNR/PSLS), Health Ministry of Benin, BP 1258, Cotonou, Benin
| | - Nicole Vidal
- UMI233-TransVIHMI, IRD (Institut de Recherche pour le développement), U1175 (INSERM) et Université de Montpellier, Montpellier, France
| | | | - Olga Sekpe
- National Reference Laboratory of Health Program Fighting Against AIDS in Benin (LNR/PSLS), Health Ministry of Benin, BP 1258, Cotonou, Benin
| | - Hermione G. Dagba
- National Reference Laboratory of Health Program Fighting Against AIDS in Benin (LNR/PSLS), Health Ministry of Benin, BP 1258, Cotonou, Benin
| | - Eric Gbaguidi
- Health Program Fighting Against AIDS in Benin (PSLS), Health Ministry of Benin, Cotonou, Benin
| | - Conrad Tonoukouen
- Health Program Fighting Against AIDS in Benin (PSLS), Health Ministry of Benin, Cotonou, Benin
| | - Aldric Afangnihoun
- Centre de Traitement Ambulatoire de l’Hôpital de zone de Suru Léré, Cotonou, Benin
| | - Moussa Bachabi
- Health Program Fighting Against AIDS in Benin (PSLS), Health Ministry of Benin, Cotonou, Benin
| | - Flore A. Gangbo
- Health Program Fighting Against AIDS in Benin (PSLS), Health Ministry of Benin, Cotonou, Benin
| | - Halimatou Diop-Ndiaye
- Institute for Health Research, Epidemiological Surveillance and Training of Senegal, Dakar, Senegal
| | - Coumba Toure-Kane
- Institute for Health Research, Epidemiological Surveillance and Training of Senegal, Dakar, Senegal
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Mboup A, Béhanzin L, Guédou F, Giguère K, Geraldo N, Zannou DM, Kêkê RK, Bachabi M, Gangbo F, Affolabi D, Marzinke MA, Hendrix C, Diabaté S, Alary M. Comparison of adherence measurement tools used in a pre-exposure prophylaxis demonstration study among female sex workers in Benin. Medicine (Baltimore) 2020; 99:e20063. [PMID: 32481273 PMCID: PMC7249870 DOI: 10.1097/md.0000000000020063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Measuring adherence to PrEP (pre-exposure prophylaxis) remains challenging. Biological adherence measurements are reported to be more accurate than self-reports and pill counts but can be expensive and not suitable on a daily basis in resource-limited countries. Using data from a demonstration project on PrEP among female sex workers in Benin, we aimed to measure adherence to PrEP and compare self-report and pill count adherence to tenofovir (TFV) disoproxil fumarate (TDF) concentration in plasma to determine if these 2 measures are reliable and correlate well with biological adherence measurements. METHODS Plasma TFV concentrations were analyzed in samples collected at day 14 follow-up visit and months 6, 12, 18, and 24 (or at last visit when follow-up was shorter). Self-reported adherence was captured at day 14 follow-up visit and then quarterly by asking participants to report the number of missed pills within the last week. For pill count, medications were refilled monthly and participants were asked to bring in their medication bottles at each follow-up visit. Using generalized estimating equations adherence measured by self-report and pill count was compared to plasma drug concentrations. RESULTS Of 255 participants, 47.1% completed follow-up. Weighted optimal adherence combining data from all visits was 26.8% for TFV concentration, 56.0% by self-report and 18.9% by pill count. Adherence measured by both TFV concentrations and self-report decreased over time (P = .009 and P = .019, respectively), while the decreasing trend in adherence by pill count was not significant (P = .087). The decrease in adherence was greater using TFV concentrations than the other 2 adherence measures. CONCLUSION With high levels of misreporting of adherence using self-report and pill count, the objective biomedical assessment of adherence via laboratory testing is optimal and more accurately reflects PrEP uptake and persistence. Alternative inexpensive and accurate approaches to monitor PrEP adherence should be investigated.
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Affiliation(s)
- Aminata Mboup
- Département de médecine sociale et préventive, Université Laval
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Luc Béhanzin
- Département de médecine sociale et préventive, Université Laval
- Dispensaire IST, Cotonou, Bénin
- École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou
| | - Fernand Guédou
- Département de médecine sociale et préventive, Université Laval
- Dispensaire IST, Cotonou, Bénin
| | - Katia Giguère
- Département de médecine sociale et préventive, Université Laval
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | | | | | | | | | | | - Dissou Affolabi
- Faculté des sciences de la santé, Université d’Abomey-Calavi
- Centre national hospitalier universitaire HMK de Cotonou, Bénin
| | | | - Craig Hendrix
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Souleymane Diabaté
- Département de médecine sociale et préventive, Université Laval
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
- Université Alassane Ouattara, Bouaké, Côte d’Ivoire
| | - Michel Alary
- Département de médecine sociale et préventive, Université Laval
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
- Institut national de santé publique du Québec, Québec, Canada
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Diallo M, Béhanzin L, Guédou FA, Geraldo N, Goma-Matsétsé E, Kania D, Kêkê RK, Bachabi M, Affolabi D, Diabaté S, Gangbo F, Zannou MD, Alary M. HIV treatment response among female sex workers participating in a treatment as prevention demonstration project in Cotonou, Benin. PLoS One 2020; 15:e0227184. [PMID: 31971957 PMCID: PMC6977752 DOI: 10.1371/journal.pone.0227184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/14/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Female sex workers (FSWs) play a key role in HIV transmission in West Africa, while they have limited access to antiretroviral therapy (ART). In line with UNAIDS recommendations extending ART to all HIV-infected individuals, we conducted this demonstration project on immediate treatment as prevention (TasP) among FSWs in Cotonou, Benin. We report data on treatment response and its relation to adherence, as well as on ART-resistant genotypes. METHODS Complete follow-up varied between 12 and 24 months. At each three-monthly visit, a questionnaire was administered, clinical examinations were carried out and blood samples collected. Adherence to treatment was estimated by self-report. Viral RNA was genotyped at baseline and final visits for drug resistance. Generalized estimating equations for repeated measures with a log-binomial link were used to analyze time trends and the association between adherence and virological response to treatment. RESULTS One-hundred-seven HIV-positive and ART-naive FSWs were enrolled; 59.8% remained in the cohort till study completion and 62.6% had a final visit. Viral load<1000 (below quantification limit [<50]) was attained in 73.1% (64.6%) of participants at month-6, 84.8% (71.2%) at month-12, and 80.9% (65.1%) at the final visit. The proportion of women with suppressed (below quantification limit) viral load increased with increasing self-reported adherence (p = 0.06 (0.003), tests for trend). The proportion of participants with CD4≤500 also decreased drastically throughout follow-up (p < .0001). Twelve participants exhibited ART-resistant genotypes at baseline, but only two at their final visit. CONCLUSION Our findings indicate that TasP is widely accepted among FSWs in Cotonou and could be implemented with relative success. However, due to mobility in this population, follow-up was sub-optimal, suggesting that large geographical coverage of FSW-friendly clinics is needed for sustained treatment implementation. We also fell short of the UNAIDS objective of 90% viral suppression among treated patients, underlining the need for better adherence support programs.
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Affiliation(s)
- Mamadou Diallo
- Département de médecine sociale et préventive, Université Laval, Québec
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec–Université Laval, Québec, Canada
| | - Luc Béhanzin
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec–Université Laval, Québec, Canada
- Dispensaire IST, Centre de santé communal de Cotonou 1, Cotonou, Bénin
- Ecole Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou, Bénin
| | - Fernand A. Guédou
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec–Université Laval, Québec, Canada
- Dispensaire IST, Centre de santé communal de Cotonou 1, Cotonou, Bénin
| | - Nassirou Geraldo
- Dispensaire IST, Centre de santé communal de Cotonou 1, Cotonou, Bénin
| | | | - Dramane Kania
- National Reference Laboratory of Viral Hemorrhagic Fever Centre MURAZ, Bobo-Dioulasso, Burkina Faso
| | | | - Moussa Bachabi
- Programme Santé de Lutte contre le Sida (PSLS), Cotonou, Bénin
| | - Dissou Affolabi
- Centre national hospitalier universitaire HMK de Cotonou, Bénin
- Faculté des sciences de la santé, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Souleymane Diabaté
- Département de médecine sociale et préventive, Université Laval, Québec
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec–Université Laval, Québec, Canada
- Université Alassane Ouattara, Bouaké, Côte d’Ivoire
| | - Flore Gangbo
- Programme Santé de Lutte contre le Sida (PSLS), Cotonou, Bénin
- Centre national hospitalier universitaire HMK de Cotonou, Bénin
- Faculté des sciences de la santé, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Marcel Djimon Zannou
- Centre national hospitalier universitaire HMK de Cotonou, Bénin
- Faculté des sciences de la santé, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Michel Alary
- Département de médecine sociale et préventive, Université Laval, Québec
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec–Université Laval, Québec, Canada
- Institut national de santé publique du Québec, Québec, Canada
- * E-mail:
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8
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Giguère K, Béhanzin L, Guédou FA, Leblond FA, Goma-Matsétsé E, Zannou DM, Affolabi D, Kêkê RK, Gangbo F, Bachabi M, Alary M. Biological Validation of Self-Reported Unprotected Sex and Comparison of Underreporting Over Two Different Recall Periods Among Female Sex Workers in Benin. Open Forum Infect Dis 2019; 6:ofz010. [PMID: 30746385 PMCID: PMC6364862 DOI: 10.1093/ofid/ofz010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/21/2018] [Accepted: 01/08/2019] [Indexed: 11/23/2022] Open
Abstract
Background Self-reported unprotected sex validity is questionable and is thought to decline with longer recall periods. We used biomarkers of semen to validate self-reported unprotected sex and to compare underreporting of unprotected sex between 2 recall periods among female sex workers (FSW). Methods At baseline of an early antiretroviral therapy and pre-exposure prophylaxis demonstration study conducted among FSW in Cotonou, Benin, unprotected sex was assessed with retrospective questionnaires, and with vaginal detection of prostate-specific antigen (PSA) and Y-chromosomal deoxyribonucleic acid (Yc-DNA). Underreporting in the last 2 or 14 days was defined as having reported no unprotected sex in the recall period while testing positive for PSA or Yc-DNA, respectively. Log-binomial regression was used to compare underreporting over the 2 recall periods. Results Unprotected sex prevalence among 334 participants was 25.8% (50.3%) according to self-report in the last 2 (or 14) days, 32.0% according to PSA, and 44.3% according to Yc-DNA. The proportion of participants underreporting unprotected sex was similar when considering the last 2 (18.9%) or 14 days (21.0%; proportion ratio = 0.90; 95% confidence interval, 0.72–1.13). Among the 107 participants who tested positive for PSA, 19 (17.8%) tested negative for Yc-DNA. Conclusions Underreporting of unprotected sex was high among FSW but did not seem to be influenced by the recall period length. Reasons for discrepancies between PSA and Yc-DNA detection, where women tested positive for PSA but negative for Yc-DNA, should be further investigated.
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Affiliation(s)
- Katia Giguère
- Centre de Recherche du CHU de Québec-Université Laval, Canada.,Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada
| | - Luc Béhanzin
- Centre de Recherche du CHU de Québec-Université Laval, Canada.,Dispensaire IST, Centre de Santé Communal de Cotonou 1, Bénin.,École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou, Bénin
| | - Fernand A Guédou
- Centre de Recherche du CHU de Québec-Université Laval, Canada.,Dispensaire IST, Centre de Santé Communal de Cotonou 1, Bénin
| | | | | | - Djimon M Zannou
- Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Bénin.,Centre National Hospitalier Universitaire HMK de Cotonou, Bénin
| | - Dissou Affolabi
- Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Bénin
| | - René K Kêkê
- Programme Santé de Lutte Contre le Sida, Cotonou, Bénin
| | - Flore Gangbo
- Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Bénin.,Centre National Hospitalier Universitaire HMK de Cotonou, Bénin.,Programme Santé de Lutte Contre le Sida, Cotonou, Bénin
| | | | - Michel Alary
- Centre de Recherche du CHU de Québec-Université Laval, Canada.,Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada.,Institut National de Santé Publique du Québec, Canada
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9
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Mboup A, Béhanzin L, Guédou FA, Geraldo N, Goma‐Matsétsé E, Giguère K, Aza‐Gnandji M, Kessou L, Diallo M, Kêkê RK, Bachabi M, Dramane K, Geidelberg L, Cianci F, Lafrance C, Affolabi D, Diabaté S, Gagnon M, Zannou DM, Gangbo F, Boily M, Vickerman P, Alary M. Early antiretroviral therapy and daily pre-exposure prophylaxis for HIV prevention among female sex workers in Cotonou, Benin: a prospective observational demonstration study. J Int AIDS Soc 2018; 21:e25208. [PMID: 31291057 PMCID: PMC6287093 DOI: 10.1002/jia2.25208] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/19/2018] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION In sub-Saharan Africa, HIV prevalence remains high, especially among key populations. In such situations, combination prevention including clinical, behavioural, structural and biological components, as well as adequate treatment are important. We conducted a demonstration project at the Dispensaire IST, a clinic dedicated to female sex workers (FSWs) in Cotonou, on early antiretroviral therapy (E-ART, or immediate "test-and-treat") and pre-exposure prophylaxis (PrEP). We present key indicators such as uptake, retention and adherence. METHODS In this prospective observational study, we recruited FSWs from October 4th 2014 to December 31st 2015 and followed them until December 31st 2016. FSWs were provided with daily tenofovir disoproxil fumarate/emtricitabine (Truvada® ) for PrEP or received a first-line antiretroviral regimen as per Benin guidelines. We used generalized estimating equations to assess trends in adherence and sexual behaviour. RESULTS Among FSWs in the catchment area, HIV testing coverage within the study framework was 95.5% (422/442). At baseline, HIV prevalence was 26.3% (111/422). Among eligible FSWs, 95.5% (105/110) were recruited for E-ART and 88.3% (256/290) for PrEP. Overall retention at the end of the study was 59.0% (62/105) for E-ART and 47.3% (121/256) for PrEP. Mean (±SD) duration of follow-up was 13.4 (±7.9) months for E-ART and 11.8 (±7.9) months for PrEP. Self-reported adherence was over 90% among most E-ART participants. For PrEP, adherence was lower and the proportion with 100% adherence decreased over time from 78.4% to 56.7% (p-trend < 0.0001). During the 250.1 person-years of follow-up among PrEP initiators, two seroconversions occurred (incidence 0.8/100 person-years (95% confidence interval: 0.3 to 1.9/100 person-years)). The two seroconverters had stopped using PrEP for at least six months before being found HIV-infected. In both groups, there was no evidence of reduced condom use. CONCLUSIONS This study provides data on key indicators for the integration of E-ART and PrEP into the HIV prevention combination package already offered to FSWs in Benin. PrEP may be more useful as an individual intervention for adherent FSWs rather than a specific public health intervention. E-ART was a more successful intervention in terms of retention and adherence and is now offered to all key populations in Benin. STUDY REGISTRATION ClinicalTrials.gov NCT02237.
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Affiliation(s)
- Aminata Mboup
- Département de médecine sociale et préventiveUniversité LavalQuébecQCCanada
- Axe Santé des populations et pratiques optimales en santéCentre de recherche du CHU de Québec – Université LavalQuébecQCCanada
| | - Luc Béhanzin
- Axe Santé des populations et pratiques optimales en santéCentre de recherche du CHU de Québec – Université LavalQuébecQCCanada
- Dispensaire ISTCentre de santé communal de Cotonou 1CotonouBénin
- École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance ÉpidémiologiqueUniversité de ParakouParakouBénin
| | - Fernand A Guédou
- Axe Santé des populations et pratiques optimales en santéCentre de recherche du CHU de Québec – Université LavalQuébecQCCanada
- Dispensaire ISTCentre de santé communal de Cotonou 1CotonouBénin
| | - Nassirou Geraldo
- Dispensaire ISTCentre de santé communal de Cotonou 1CotonouBénin
| | | | - Katia Giguère
- Département de médecine sociale et préventiveUniversité LavalQuébecQCCanada
- Axe Santé des populations et pratiques optimales en santéCentre de recherche du CHU de Québec – Université LavalQuébecQCCanada
| | | | - Léon Kessou
- Service de Consultance et Expertise Nouvelle en Afrique (SCEN AFRIK)CotonouBénin
| | - Mamadou Diallo
- Département de médecine sociale et préventiveUniversité LavalQuébecQCCanada
- Axe Santé des populations et pratiques optimales en santéCentre de recherche du CHU de Québec – Université LavalQuébecQCCanada
| | - René K Kêkê
- Programme Santé de Lutte contre le Sida (PSLS)CotonouBénin
| | - Moussa Bachabi
- Programme Santé de Lutte contre le Sida (PSLS)CotonouBénin
| | - Kania Dramane
- Laboratoire de virologie du Centre MurazBobo‐DioulassoBurkina Faso
| | - Lily Geidelberg
- Department of infectious diseaseImperial College LondonLondonUK
| | - Fiona Cianci
- University of BristolBristolUK
- London School of Hygiene and Tropical MedicineLondonUK
| | - Christian Lafrance
- Axe Santé des populations et pratiques optimales en santéCentre de recherche du CHU de Québec – Université LavalQuébecQCCanada
| | - Dissou Affolabi
- Faculté des sciences de la santéUniversité d'Abomey‐CalaviCotonouBénin
- Centre national hospitalier universitaire HMK de CotonouCotonouBénin
| | - Souleymane Diabaté
- Département de médecine sociale et préventiveUniversité LavalQuébecQCCanada
- Axe Santé des populations et pratiques optimales en santéCentre de recherche du CHU de Québec – Université LavalQuébecQCCanada
- Université Alassane OuattaraBouakéCôte d'Ivoire
| | - Marie‐Pierre Gagnon
- Axe Santé des populations et pratiques optimales en santéCentre de recherche du CHU de Québec – Université LavalQuébecQCCanada
- Faculté des sciences infirmièresUniversité LavalQuébecQCCanada
| | - Djimon M Zannou
- Faculté des sciences de la santéUniversité d'Abomey‐CalaviCotonouBénin
- Centre national hospitalier universitaire HMK de CotonouCotonouBénin
| | - Flore Gangbo
- Programme Santé de Lutte contre le Sida (PSLS)CotonouBénin
- Faculté des sciences de la santéUniversité d'Abomey‐CalaviCotonouBénin
- Centre national hospitalier universitaire HMK de CotonouCotonouBénin
| | - Marie‐Claude Boily
- Axe Santé des populations et pratiques optimales en santéCentre de recherche du CHU de Québec – Université LavalQuébecQCCanada
- Department of infectious diseaseImperial College LondonLondonUK
| | | | - Michel Alary
- Département de médecine sociale et préventiveUniversité LavalQuébecQCCanada
- Axe Santé des populations et pratiques optimales en santéCentre de recherche du CHU de Québec – Université LavalQuébecQCCanada
- Institut national de santé publique du QuébecQuébecQCCanada
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Sossa Jerome C, Agonnoudé M, Sopoh GE, Bah-Chabi AI, De Souza A, Bachabi M, Gbetowenonmon G, Agueh V, Ouendo EM, Ouédraogo L. Sociodemographic, lifestyle and therapeutic predictors of 2-year survival in HIV-infected persons receiving antiretroviral therapy in Benin. J Public Health Afr 2017. [DOI: 10.4081/jphia.2017.651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The benefits of antiretroviral therapy (ART) for treating human immunodeficiency virus (HIV) infection have been well described. The objective of this study was to identify the predictors of two-year survival in persons living with HIV/AIDS (PLWHA) in Benin. This retrospective transversal study included all patients from 46 HIV/AIDS therapy sites across Benin who started ART between July 1st, 2011 and June 30th, 2012. The independent variables were patients’ sociodemographic, clinical, biological and therapeutic characteristics and their ART regimen. The main dependent variable was the time of death. Data were collected from medical records, using documentary review. Cox proportional hazards regression models were used to investigate factors associated with survival. Among the 771 PLWHA participants of the study, 18 (2.3%) died within the two-year period. The estimated mortality of the 771 PLWHA was 3% at 24 months. Among the sociodemographic, lifestyle and therapeutic characteristics studied, the main predictor of two-year mortality was poor adherence [odds ratio = 4.15, 95% confidence interval (1.55- 11.28)]. This study confirms that improving the survival of PLWHA receiving ART requires enhanced adherence.
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11
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Jerome CS, Agonnoudé M, Sopoh GE, Bah-Chabi AI, de Souza A, Bachabi M, Gbetowenonmon G, Agueh V, Ouendo EM, Ouédraogo L. Sociodemographic, lifestyle and therapeutic predictors of 2- year survival in HIV-infected persons receiving antiretroviral therapy in Benin. J Public Health Afr 2017; 8:651. [PMID: 29071057 PMCID: PMC5641827 DOI: 10.4081/jphia.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/27/2017] [Accepted: 05/31/2017] [Indexed: 11/17/2022] Open
Affiliation(s)
- Charles Sossa Jerome
- National Program for Fight against AIDS (PNLS); ,Regional Institute of Public Health, University of Abomey-Calavi; ,Correspondence: Charles Sossa Jerome, Department of Health Promotion, Regional Institute of Public Health, PO Box 384 Ouidah, Benin. +229.66278085.
| | - Maurice Agonnoudé
- National School of Epidemiology and Public Health, University of Parakou, Benin
| | | | | | | | | | | | - Victoire Agueh
- Regional Institute of Public Health, University of Abomey-Calavi;
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