Immuno-virological response and associated factors amongst HIV-1 vertically infected adolescents in Yaoundé-Cameroon.

TitleImmuno-virological response and associated factors amongst HIV-1 vertically infected adolescents in Yaoundé-Cameroon.
Publication TypeJournal Article
Year of Publication2017
AuthorsFokam J, Billong SClotaire, Jogue F, Ndiang SMoyo Tetan, Motaze ACarole Nga, Paul KNdombo, Nlend AEsther Njo
JournalPLoS One
Volume12
Issue11
Paginatione0187566
Date Published2017
ISSN1932-6203
KeywordsAdolescent, Anti-HIV Agents, Cameroon, Cross-Sectional Studies, Female, HIV Infections, HIV-1, Humans, Infectious Disease Transmission, Vertical, Male, Viral Load
Abstract

INTRODUCTION: Limited studies have reported the outcomes of lifelong antiretroviral therapy (ART) amongst adolescents living with HIV (ALWHIV) in resource-limited settings (RLS), thus classifying this population as underserved. We therefore aimed to ascertain the immunological and virological responses, and associated factors amongst Cameroonian ALWHIV.

METHOD: A cross-sectional and observational study was conducted from January through May 2016 at the National Social Insurance Fund Health Centre in Yaoundé-Cameroon. Immunological and virological responses were evaluated using CD4 cell count and viral load respectively, with viral suppression (VS) defined as <50 copies/ml. Adherence was evaluated using self-reported missing doses during the past 14 days. Data were analyzed using R v.3.3.0, with p<0.05 considered statistically significant.

RESULTS: Of the 145 ALWHIV on ART enrolled in the study, 52% were female, median age [interquartile (IQR)] was 13 [11-16] years, median [IQR] time-on-ART was 7 [5-10] years, 48% were orphans, 92% were on first-line ART and 36% were adherent to ART. Following ART response, 79% (114/145) had CD4 ≥500/mm3, 71.0% (103/145) were on VS of whom 52.4% (76/145) had a sustained VS. Duration of ART was associated with immune restoration (Odd Ratio 3.73 [1.26-12.21]) but not with virological response. Risks of poor adherence were greater in orphans of both parents (p = 0.078).

CONCLUSION: In this urban setting of Cameroon, ALWHIV receiving ART show favorable immunological and virological response in a medium run. For long-term ART success, implementing a close monitoring of adherence and risks of viral rebound would be highly relevant, especially for orphans of both parents.

DOI10.1371/journal.pone.0187566
Alternate JournalPLoS ONE
PubMed ID29112991
PubMed Central IDPMC5675438
French