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Infection à VIH-2 au Sénégal: échecs virologiques et résistances aux antirétroviraux (ARV)

INTRODUCTION: HIV-2, endemic in West Africa, has a natural resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) which makes it difficult to treat it in developing countries. METHODS: We conducted a descriptive, longitudinal, prospective study over the period November 2005-June 2017...

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Detalles Bibliográficos
Autores principales: Ba, Selly, Dia-Badiane, Ndeye Mery, Hawes, Stephen Edward, Deguenonvo, Louise Fortes, Sall, Fatima, Ndour, Cheikh Tidiane, Faye, Khadim, Traoré, Fatou, Touré, Macoumba, Sy, Marie Pierre, Raugi, Dana Noelle, Kiviat, Nancy Berenice, Smith, Robert Alexander, Seydi, Moussa, Sow, Papa Salif, Gottlieb, Geoffrey Scott
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6814923/
https://www.ncbi.nlm.nih.gov/pubmed/31692792
http://dx.doi.org/10.11604/pamj.2019.33.222.15771
Descripción
Sumario:INTRODUCTION: HIV-2, endemic in West Africa, has a natural resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) which makes it difficult to treat it in developing countries. METHODS: We conducted a descriptive, longitudinal, prospective study over the period November 2005-June 2017. Virologic failure has been defined as any viral load greater than 50 copies/ml after 6 months of ARV treatment administered twice. Assays for detecting drug-resistance mutations was performed in the protease-coding region and in the reverse transcriptase-coding region. RESULTS: Data from a total of 110 patients were collected. The patients had a median age of 46 years (ranging from 18 to 67) with a sex-ratio F/M of 2.54. At inclusion, viral load could be assessed in 44% of cases with a median of 935cp/ml (ranging from 17 to 144038). Antiretroviral regimen consisted of a combination of 2 NRTIs and 1IP in 94% of cases. The median follow-up was 1200 days (ranging from 1 to 3840); 94 then 76 patients completed their 12-month and 24-month assessments respectively. At 24-month follow-up, 39 patients had virologic failure, reflecting a prevalence of 39% estimated at 33% at 12-month follow-up and at 11% at 24-month follow-up; NRTIs resistance was observed in 45% of patients, IP resistance in 41% of patients while multi-NRTIs resistance and multi-IP resistance in 30% of patients. CONCLUSION: Currently, there is an urgent need to make available the new therapeutic classes of ARV for second line ART for patients living with HIV-2 with therapeutic failure in resource-limited settings.