Immuno-haematologic and virologic responses and predictors of virologic failure in HIV-1 infected adults on first-line antiretroviral therapy in Cameroon  

作　　者：Henry D Meriki Kukwah A Tufon Mbunkah H Afegenwi Bernard A Nyindem Pascal N Atanga Damian N Anong Fidelis Cho-Ngwa Theresa Nkuo-Akenji 

机构地区：[1]Department of Microbiology and Parasitology,University of Buea,P.O.Box 63,Buea,Cameroon [2]BioCollections Worldwide Inc.Regional Office,Buea,Cameroon [3]Regional Delegation of Public Health,Southwest Region,Cameroon [4]Faculty of Science Clinical Diagnostic Laboratory,University of Buea,Buea,Cameroon

出　　处：《Infectious Diseases of Poverty》2014年第1期29-39,共11页贫困所致传染病（英文）

基　　金：BioCollections Worldwide Inc.,Miami,Florida,USA,provided financial support and performed viral load analysis;Financial assistance was also received from the University of Buea 2009-2010 Research Grant awarded to Professor Theresa Nkuo-Akenji.

摘　　要：Background:Contemporary data on the immunologic,haematologic and virologic responses and predictors of virologic failure after initiation of free antiretroviral treatment in Cameroon are needed to evaluate the current treatment-monitoring algorithm and to complement efforts to scale-up and improve on the management of HIV infections.Methods:This was a cross-sectional study conducted between October 2010 and June 2012.A total of 951 participants aged 18-74 years were recruited from selected approved HIV treatment centres of the Northwest and Southwest regions.This comprised 247 males and 704 females.Demographic,self-reported risk behaviours and socioeconomic data were obtained using a structured questionnaire.Full blood and CD4+T-cell counts were done using standard automated techniques.Determination of viral load(VL)was done using Abbott RealTime HIV-1 m2000™system.Data was analysed using SPSS version 17.The statistical significance level was P<0.05.Results:The median duration of antiretroviral therapy(ART)was 24 months.The population mean CD4+T-cell count was 255.3 cells/μL[95%CI,236.8-273.9].Overall,45.9%,43.8%and 10.2%of the participants had CD4+T-cell counts of<200 cells/μL,200-499 cells/μL and>500 cells/μL respectively.Anaemia was present in 26.2%of the participants with 62.3%,25.7%and 12%described as mild,moderate and severe anaemia respectively.Virologic failure occurred in 23.2%of the participants with 12.3%having VL>10,000 RNA copies/mL.Meanwhile 76.8%of patients attained adequate viral suppression with 40.8%having undetectable viral load.The age group 18-29 years(p=0.024),co-infection with tuberculosis(p=0.014),anaemia(p=0.028)and distance from the treatment centre(p=0.011)independently predicted virologic failure.Conclusion:The majority of the participants achieved adequate viral suppression after≥6 months of ART.Despite these favourable immuno-haematologic and virologic outcomes,the National AIDS Control Program should step-up efforts to improve on antiretroviral drug distribution,as well as p

关 键 词：Immuno-haematologic PREDICTORS Virologic failure Antiretroviral therapy 

分 类 号：R51[医药卫生—内科学]