• Joseph Fokam, Alex Durand Nka, Flore Yollande Mamgue Dzukam, Jeremiah Efakika Gabisa, Yagai Bouba, Michel Carlos Tommo Tchouaket, Aude Christelle Ka'e, Ezechiel Ngoufack Jagni Semengue, Desire Takou, Sylvie Moudourou, Nadine Fainguem, Willy Pabo, Rachel Audrey Nayang Mundo, Aurelie Minelle Kengni Ngueko, Collins Ambe Chenwi, Junie Flore Yimga, Marie Krystel Nnomo Zam, Rachel Simo Kamgaing, Charlotte Tangimpundu, Nelly Kamgaing, Anne-Esther Njom-Nlend, Paul Ndombo Koki, Daniel Kesseng, Suzie Ndiang Tetang, Etienne Kembou, Lifanda Ebiama Lifanda, Bouba Pamen, Alice Ketchaji, Edith Saounde Temgoua, Serge Clotaire Billong, Anne-Cecile Zoung-Kanyi Bissek, Hamsatou Hadja, Edie Gregory Halle, Vittorio Colizzi, Carlo-Federico Perno, Samuel Martin Sosso, and Alexis Ndjolo.
• Chantal BIYA International Reference Centre for research on HIV/AIDS Prevention and Management, Yaoundé, Cameroon.
• Medicine (Baltimore). 2023 May 19; 102 (20): e33737e33737.

AbstractThis study aimed to compare viral suppression (VS) between children, adolescents, and adults in the frame of transition to dolutegravir (DTG)-based antiretroviral therapy (ART) in the Cameroonian context. A comparative cross-sectional study was conducted from January 2021 through May 2022 amongst ART-experienced patients received at the Chantal BIYA International Reference Centre in Yaounde-Cameroon, for viral load (VL) monitoring. VS was defined as VL < 1000 copies/mL and viral undetectability as VL < 50 copies/mL. Chi-square and multivariate binary logistic regression models were used to identify factors associated with VS. Data were analyzed using SPSS v.20.0 (SPSS Inc., Chicago, Illinois), with P < .05 considered significant. A total of 9034 patients (72.2% females) were enrolled. In all, there were 8585 (95.0%) adults, 227 (2.5%) adolescents, and 222 (2.5%) children; 1627 (18.0%) were on non-nucleoside reverse transcriptase-based, 290 (3.2%) on PI-based, and 7117 (78.8%) on DTG-based ART. Of those on DTG-based ART, only 82 (1.2%) were children, 138 (1.9%) adolescents, and 6897 (96.9%) adults. Median (interquartile range) duration on ART was 24 (12-72) months (24 months on Tenofovir + Lamivudine + Dolutegravir [TLD], 36 months on other first lines, and 84 months on protease inhibitors boosted with ritonavir-based regimens). Overall, VS was 89.8% (95% confidence interval: 89.2-90.5) and viral undetectability was 75.7% (95% confidence interval: 74.8-76.7). Based on ART regimen, VS on Non-nucleoside reverse transcriptase-based, protease inhibitors boosted with ritonavir-based, and DTG-based therapy was respectively 86.4%, 59.7%, and 91.8%, P < .0001. Based on ART duration, VS was respectively 51.7% (≤24 months) versus 48.3% (≥25 months), P < .0001. By gender, VS was 90.9% (5929) in females versus 87.0% (2183) in males, P < .0001; by age-range, VS moved from 64.8% (144) in children, 74.4% (169) adolescents, to 90.8% (7799) adults, P < .0001. Following multivariate analysis, VS was associated with adulthood, female gender, TLD regimens, and combination antiretroviral therapy duration > 24 months (P < .05). In Cameroon, ART response indicates encouraging rates of VS (about 9/10) and viral undetectability (about 3/4), driven essentially by access to TLD based regimens. However, ART response was very poor in children, underscoring the need for scaling-up pediatric DTG-based regimens.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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