Incidence of infectious morbidity events after second-line antiretroviral therapy initiation in HIV-infected adults in Yaoundé, Cameroon.
|Titre||Incidence of infectious morbidity events after second-line antiretroviral therapy initiation in HIV-infected adults in Yaoundé, Cameroon.|
|Publication Type||Journal Article|
|Year of Publication||2016|
|Authors||Galy A, Ciaffi L, Le Moing V, Eymard-Duvernay S, Abessolo H, Toby R, Ayangma L, Le Gac S, Mpoudi-Etame M, Koulla-Shiro S, Delaporte E, Cournil A|
|Corporate Authors||2LADY Study Group|
|Mots-clés||Adult, AIDS-Related Opportunistic Infections, Anti-HIV Agents, Cameroon, CD4 Lymphocyte Count, Female, HIV Infections, HIV-1, Humans, Incidence, Male, Middle Aged, Morbidity, Prospective Studies, Treatment Failure|
BACKGROUND: Since antiretroviral therapy (ART), HIV-infected individuals experience mainly non-AIDS-related conditions, among which infectious events are prominent. We aimed to estimate incidence and describe overall spectrum of infectious events, including all grade events, among HIV-1-infected adults failing first-line ART in Yaoundé, Cameroon.
METHODS: All patients from Cameroon enrolled in the second-line ART 2LADY trial (ANRS12169) were included in this secondary analysis. Medical files were reviewed with predefined criteria for diagnosis assessment. Incidence rates (IR) were estimated per 100 person-years (% PY).
RESULTS: A total of 302 adult patients contributing 840 PY experienced 596 infectious events (IR 71% PY). Only 29 (5%) events were graded as severe. Most frequent infections were upper respiratory tract infections (15% PY), diarrhoea (9% PY) and malaria (9% PY). A total of 369 (62%) infections occurred during the first year (IR 130% PY) followed by a persistent lower incidence during the following 3 years. Higher IR were observed in patients with CD4 T-cell count <200 cells/mm for all infectious events except for mycobacterial and parasitic infections. IR of viral, bacterial and parasitic infectious events were lower in case of co-trimoxazole use in patients with CD4 T-cell count <200 cells/mm.
CONCLUSIONS: Infectious events are common and mainly occur during the first year after treatment initiation. Second-line ART initiation had a positive impact on the entire spectrum of infectious morbidity.
|Alternate Journal||Antivir. Ther. (Lond.)|