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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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