Conference abstract
Dolutegravir based regimen ensures high virological success despite prior exposure to Efavirenz based first-line ART: a comparative study in Cameroon
Pan African Medical Journal - Conference Proceedings. 2023:18(96).03
Oct 2023.
doi: 10.11604/pamj-cp.2023.18.96.2191
Archived on: 03 Oct 2023
Contact the corresponding author
Keywords: HIV, antiretrovirals, first-line, TLD, virological-response, Cameroon
Oral presentation
Dolutegravir based regimen ensures high virological success despite prior exposure to Efavirenz based first-line ART: a comparative study in Cameroon
Ezechiel Ngoufack Jagni Semengue1,&, Naomi-Karell Etame1, Evariste Molimbou1, Joseph Fokam1, Désiré Takou1, Leonella Mossiang1, Alain P Meledie1, Collins Ambe Chenwi1, Bouba Yagai1, Alex Durand Nka1, Beatrice Dambaya1, Georges Teto1, Aude Christelle Ka’e1, Grâce Angong Beloumou1, Sandrine Claire Djupsa Ndjeyep1, Aissatou Abba1, Aurelie Minelle Ngueko Kengni1, Michel Carlos Tommo Tchouaket1, Nounouce Pamen Bouba1, Serges Clotaire Billong1, Samuel Martin Sosso1, Vittorio Colizzi2, Carlo-Federico Perno2, Charles Kouanfack3, Anne-Cécile Zoung-Kanyi Bissek4, Emmanuel Eben Moussi1, Maria Mercedes Santoro2, Francesca Ceccherini-Silberstein2, Alexis Ndjolo1
1Centre International de Reference Chantal BIYA pour la Recherche sur la Prévention et la Prise en Charge du VIH/SIDA (CIRCB), Yaoundé, Cameroun, 2Université de Rome Tor Vergata, Rome, Italie, 3Hopital Central de Yaoundé, Yaoundé, Cameroun, 4Faculté de Médecine et des Sciences Biomédicales, Yaoundé I, Yaoundé, Cameroun
&Corresponding author
Introduction: to ensure optimal prescribing practices in the dolutegravir-era in Cameroon, we compared first-line virological response(VR) under Tenofovir+Lamivudine+Dolutegravir (TLD) according to prior exposure to Tenofovir+Lamivudine+Efavirenz (TLE). The main objective of our study was to evaluate the virological response in patients undergoing first-line treatment with DTG in Cameroon
Methods: a comparative study was conducted in June-December 2021 among patients initiating antiretroviral therapy with TLD (I-TLD) vs. those transitioning from TLE to TLD (T-TLD) in HIV treatment centres of Yaounde and Douala, Cameroon. HIV viral load was performed on Abbott m2000rt or OPP-ERA platforms (detection thresholds, <40 and <390 copies/ml, respectively). For participants with viremia >390 copies/ml, genotyping was performed by Sanger-sequencing; mutations were interpreted using HIVdb.v9.1, and a phylogenetic tree was constructed using MEGA.v7; all p-values<0.05 were considered statistically significant.
Results: of the 12,093 patients followed, 310 (mean-age: 41±11years; 52.26%female) complied with study criteria (171 I-TLD vs. 139 T-TLD). Median [IQR] ART duration was 14 [12-17] months among I-TLDs vs. 28 [24.5-31] months among T-TLDs (i.e. 15 [11-19] months on TLE and 14 [9-15] months on TLD), and 83.15% (148/178) were at WHO clinical stages I/II. Overall viral suppression rate (<1000copies/ml) was 96.45% (299/310), with 97.08% (166/171) among I-TLDs vs. 95.68% (133/139) among T-TLDs (p=0.55). Additionally, VR was similar in I-TLD vs. T-TLD at < 400 copies/ml (94.15% vs. 94.42%).
Conclusion: viral suppression is optimal under first-line TLD after 14 months, even with prior exposure to TLE. This evidence confirms the effectiveness of a transition from TLE to TLD in similar African settings, supported by the strong pharmacological potency and genetic barrier of dolutegravir toward the global elimination of AIDS by 2030.
Dolutegravir based regimen ensures high virological success despite prior exposure to Efavirenz based first-line ART: a comparative study in Cameroon
Ezechiel Ngoufack Jagni Semengue1,&, Naomi-Karell Etame1, Evariste Molimbou1, Joseph Fokam1, Désiré Takou1, Leonella Mossiang1, Alain P Meledie1, Collins Ambe Chenwi1, Bouba Yagai1, Alex Durand Nka1, Beatrice Dambaya1, Georges Teto1, Aude Christelle Ka’e1, Grâce Angong Beloumou1, Sandrine Claire Djupsa Ndjeyep1, Aissatou Abba1, Aurelie Minelle Ngueko Kengni1, Michel Carlos Tommo Tchouaket1, Nounouce Pamen Bouba1, Serges Clotaire Billong1, Samuel Martin Sosso1, Vittorio Colizzi2, Carlo-Federico Perno2, Charles Kouanfack3, Anne-Cécile Zoung-Kanyi Bissek4, Emmanuel Eben Moussi1, Maria Mercedes Santoro2, Francesca Ceccherini-Silberstein2, Alexis Ndjolo1
1Centre International de Reference Chantal BIYA pour la Recherche sur la Prévention et la Prise en Charge du VIH/SIDA (CIRCB), Yaoundé, Cameroun, 2Université de Rome Tor Vergata, Rome, Italie, 3Hopital Central de Yaoundé, Yaoundé, Cameroun, 4Faculté de Médecine et des Sciences Biomédicales, Yaoundé I, Yaoundé, Cameroun
&Corresponding author
Introduction: to ensure optimal prescribing practices in the dolutegravir-era in Cameroon, we compared first-line virological response(VR) under Tenofovir+Lamivudine+Dolutegravir (TLD) according to prior exposure to Tenofovir+Lamivudine+Efavirenz (TLE). The main objective of our study was to evaluate the virological response in patients undergoing first-line treatment with DTG in Cameroon
Methods: a comparative study was conducted in June-December 2021 among patients initiating antiretroviral therapy with TLD (I-TLD) vs. those transitioning from TLE to TLD (T-TLD) in HIV treatment centres of Yaounde and Douala, Cameroon. HIV viral load was performed on Abbott m2000rt or OPP-ERA platforms (detection thresholds, <40 and <390 copies/ml, respectively). For participants with viremia >390 copies/ml, genotyping was performed by Sanger-sequencing; mutations were interpreted using HIVdb.v9.1, and a phylogenetic tree was constructed using MEGA.v7; all p-values<0.05 were considered statistically significant.
Results: of the 12,093 patients followed, 310 (mean-age: 41±11years; 52.26%female) complied with study criteria (171 I-TLD vs. 139 T-TLD). Median [IQR] ART duration was 14 [12-17] months among I-TLDs vs. 28 [24.5-31] months among T-TLDs (i.e. 15 [11-19] months on TLE and 14 [9-15] months on TLD), and 83.15% (148/178) were at WHO clinical stages I/II. Overall viral suppression rate (<1000copies/ml) was 96.45% (299/310), with 97.08% (166/171) among I-TLDs vs. 95.68% (133/139) among T-TLDs (p=0.55). Additionally, VR was similar in I-TLD vs. T-TLD at < 400 copies/ml (94.15% vs. 94.42%).
Conclusion: viral suppression is optimal under first-line TLD after 14 months, even with prior exposure to TLE. This evidence confirms the effectiveness of a transition from TLE to TLD in similar African settings, supported by the strong pharmacological potency and genetic barrier of dolutegravir toward the global elimination of AIDS by 2030.
