Alarming rates of virological failure and HIV‐1 drug resistance amongst adolescents living with perinatal HIV in both urban and rural settings: evidence from the EDCTP READY‐study in Cameroon

• Published in: HIV medicine 2021-08, Vol.22 (7), p.567-580
• Main Authors: Fokam, J, Takou, D, Njume, D, Pabo, W, Santoro, MM, Njom Nlend, A‐E, Beloumou, G, Sosso, S, Moudourou, S, Teto, G, Dambaya, B, Djupsa, S, Tetang Ndiang, S, Ateba, FN, Billong, SC, Kamta, C, Bala, L, Lambo, V, Tala, V, Chenwi Ambe, C, Mpouel, ML, Cappelli, G, Cham, F, Ndip, R, Mbuagbaw, L, Koki Ndombo, P, Ceccherini‐Silberstein, F, Colizzi, V, Perno, C‐F, Ndjolo, A
• Format: Article
• Language: English
• Subjects: adherence; Adolescent; Adolescents; Anti-HIV Agents - pharmacology; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Cameroon; Cameroon - epidemiology; CD4 antigen; CD4 count; Drug resistance; Drug Resistance, Viral; Failure rates; Female; Gender; Geographical distribution; Geographical locations; Health care facilities; HIV; HIV drug resistance; HIV Infections - drug therapy; HIV-1; Human immunodeficiency virus; Humans; Immunology; Non-nucleoside reverse transcriptase inhibitors; Resistance factors; RNA-directed DNA polymerase; Teenagers; Urban areas; Urban environments; Viral Load
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/hiv.13095

Objectives Adolescents living with perinatal HIV infection (ALPHI) experience persistently high mortality rates, particularly in resource‐limited settings. It is therefore clinically important for us to understand the therapeutic response, acquired HIV drug resistance (HIVDR) and associated factors among ALPHI, according to geographical location. Methods A study was conducted among consenting ALPHI in two urban and two rural health facilities in the Centre Region of Cameroon. World Health Organization (WHO) clinical staging, self‐reported adherence, HIVDR early warning indicators (EWIs), immunological status (CD4 count) and plasma viral load (VL) were assessed. For those experiencing virological failure (VF, VL ≥ 1000 copies/mL), HIVDR testing was performed and interpreted using the Stanford HIV Drug Resistance Database v.8.9–1. Results Of the 270 participants, most were on nonnucleoside reverse transcriptase inhibitor (NNRTI)‐based regimens (61.7% urban vs. 82.2% rural), and about one‐third were poorly adherent (30.1% vs. 35.1%). Clinical failure rates (WHO‐stage III/IV) in both settings were