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Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model
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). A facility-based survey was conducted among patient...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866637/ https://www.ncbi.nlm.nih.gov/pubmed/36680058 http://dx.doi.org/10.3390/v15010018 |
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author | Semengue, Ezechiel Ngoufack Jagni Fokam, Joseph Etame, Naomi-Karell Molimbou, Evariste Chenwi, Collins Ambe Takou, Désiré Mossiang, Leonella Meledie, Alain P. Yagai, Bouba Nka, Alex Durand Dambaya, Beatrice Teto, Georges Ka’e, Aude Christelle Beloumou, Grâce Angong Djupsa Ndjeyep, Sandrine Claire Abba, Aissatou Kengni, Aurelie Minelle Ngueko Tommo Tchouaket, Michel Carlos Bouba, Nounouce Pamen Billong, Serge-Clotaire Sosso, Samuel Martin Colizzi, Vittorio Perno, Carlo-Federico Kouanfack, Charles Zoung-Kanyi Bissek, Anne-Cecile Eben-Moussi, Emmanuel Santoro, Maria Mercedes Ceccherini-Silberstein, Francesca Ndjolo, Alexis |
author_facet | Semengue, Ezechiel Ngoufack Jagni Fokam, Joseph Etame, Naomi-Karell Molimbou, Evariste Chenwi, Collins Ambe Takou, Désiré Mossiang, Leonella Meledie, Alain P. Yagai, Bouba Nka, Alex Durand Dambaya, Beatrice Teto, Georges Ka’e, Aude Christelle Beloumou, Grâce Angong Djupsa Ndjeyep, Sandrine Claire Abba, Aissatou Kengni, Aurelie Minelle Ngueko Tommo Tchouaket, Michel Carlos Bouba, Nounouce Pamen Billong, Serge-Clotaire Sosso, Samuel Martin Colizzi, Vittorio Perno, Carlo-Federico Kouanfack, Charles Zoung-Kanyi Bissek, Anne-Cecile Eben-Moussi, Emmanuel Santoro, Maria Mercedes Ceccherini-Silberstein, Francesca Ndjolo, Alexis |
author_sort | Semengue, Ezechiel Ngoufack Jagni |
collection | PubMed |
description | 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). A facility-based survey was conducted among patients initiating antiretroviral therapy (ART) with TLD (I-TLD) versus those transitioning from TLE to TLD (T-TLD). HIV viral load was performed and unsuppressed participants (VL > 1000 copies/mL) had genotyping performed by Sanger sequencing. Of the 12,093 patients followed, 310 (mean-age: 41 ± 11 years; 52.26% female) complied with study criteria (171 I-TLD vs. 139 T-TLD). The median ART-duration was 14 (12–17) months among I-TLDs versus 28 (24.5–31) months among T-TLDs (15 (11–19) on TLE and 14 (9–15) on TLD), and 83.15% (148/178) were at WHO clinical stages I/II. The viral suppression rate (<1000 copies/mL) was 96.45%, with 97.08% among I-TLDs versus 95.68% among T-TLDs (p = 0.55). VR was similar in I-TLD versus T-TLD at <400 copies/mL (94.15% versus 94.42%) and age, gender, residence, ART-duration, and WHO stages were not associated with VR (p > 0.05). Genotyping was successful for 72.7% (8/11), with no major mutations to integrase inhibitors found. VR is optimal under first-line TLD after 14 months, even among TLE-exposed, thus confirming the effectiveness of transitioning from TLE to TLD in similar settings, supported by strong pharmacological potency and genetic barrier of dolutegravir. |
format | Online Article Text |
id | pubmed-9866637 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98666372023-01-22 Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model Semengue, Ezechiel Ngoufack Jagni Fokam, Joseph Etame, Naomi-Karell Molimbou, Evariste Chenwi, Collins Ambe Takou, Désiré Mossiang, Leonella Meledie, Alain P. Yagai, Bouba Nka, Alex Durand Dambaya, Beatrice Teto, Georges Ka’e, Aude Christelle Beloumou, Grâce Angong Djupsa Ndjeyep, Sandrine Claire Abba, Aissatou Kengni, Aurelie Minelle Ngueko Tommo Tchouaket, Michel Carlos Bouba, Nounouce Pamen Billong, Serge-Clotaire Sosso, Samuel Martin Colizzi, Vittorio Perno, Carlo-Federico Kouanfack, Charles Zoung-Kanyi Bissek, Anne-Cecile Eben-Moussi, Emmanuel Santoro, Maria Mercedes Ceccherini-Silberstein, Francesca Ndjolo, Alexis Viruses Article 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). A facility-based survey was conducted among patients initiating antiretroviral therapy (ART) with TLD (I-TLD) versus those transitioning from TLE to TLD (T-TLD). HIV viral load was performed and unsuppressed participants (VL > 1000 copies/mL) had genotyping performed by Sanger sequencing. Of the 12,093 patients followed, 310 (mean-age: 41 ± 11 years; 52.26% female) complied with study criteria (171 I-TLD vs. 139 T-TLD). The median ART-duration was 14 (12–17) months among I-TLDs versus 28 (24.5–31) months among T-TLDs (15 (11–19) on TLE and 14 (9–15) on TLD), and 83.15% (148/178) were at WHO clinical stages I/II. The viral suppression rate (<1000 copies/mL) was 96.45%, with 97.08% among I-TLDs versus 95.68% among T-TLDs (p = 0.55). VR was similar in I-TLD versus T-TLD at <400 copies/mL (94.15% versus 94.42%) and age, gender, residence, ART-duration, and WHO stages were not associated with VR (p > 0.05). Genotyping was successful for 72.7% (8/11), with no major mutations to integrase inhibitors found. VR is optimal under first-line TLD after 14 months, even among TLE-exposed, thus confirming the effectiveness of transitioning from TLE to TLD in similar settings, supported by strong pharmacological potency and genetic barrier of dolutegravir. MDPI 2022-12-21 /pmc/articles/PMC9866637/ /pubmed/36680058 http://dx.doi.org/10.3390/v15010018 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Semengue, Ezechiel Ngoufack Jagni Fokam, Joseph Etame, Naomi-Karell Molimbou, Evariste Chenwi, Collins Ambe Takou, Désiré Mossiang, Leonella Meledie, Alain P. Yagai, Bouba Nka, Alex Durand Dambaya, Beatrice Teto, Georges Ka’e, Aude Christelle Beloumou, Grâce Angong Djupsa Ndjeyep, Sandrine Claire Abba, Aissatou Kengni, Aurelie Minelle Ngueko Tommo Tchouaket, Michel Carlos Bouba, Nounouce Pamen Billong, Serge-Clotaire Sosso, Samuel Martin Colizzi, Vittorio Perno, Carlo-Federico Kouanfack, Charles Zoung-Kanyi Bissek, Anne-Cecile Eben-Moussi, Emmanuel Santoro, Maria Mercedes Ceccherini-Silberstein, Francesca Ndjolo, Alexis Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model |
title | Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model |
title_full | Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model |
title_fullStr | Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model |
title_full_unstemmed | Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model |
title_short | Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model |
title_sort | dolutegravir-based regimen ensures high virological success despite prior exposure to efavirenz-based first-line art in cameroon: an evidence of a successful transition model |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866637/ https://www.ncbi.nlm.nih.gov/pubmed/36680058 http://dx.doi.org/10.3390/v15010018 |
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