1. Incidence of Infectious Morbidity Events after Second-Line Antiretroviral Therapy Initiation in HIV-Infected Adults in Yaoundé, Cameroon
- Author
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Le Gac S, Eric Delaporte, Roselyne Toby, Sabrina Eymard-Duvernay, Mpoudi-Etame M, Le Moing, Laura Ciaffi, Amandine Cournil, Galy A, Hermine Abessolo, Ayangma L, Sinata Koulla-Shiro, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
- Subjects
Adult ,Male ,medicine.medical_specialty ,Anti-HIV Agents ,AIDS-Related Opportunistic Infections ,HIV Infections ,03 medical and health sciences ,0302 clinical medicine ,Second line ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Hiv infected ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Cameroon ,Prospective Studies ,Treatment Failure ,030212 general & internal medicine ,Prospective cohort study ,Pharmacology ,Respiratory tract infections ,business.industry ,Incidence ,030503 health policy & services ,Incidence (epidemiology) ,Middle Aged ,medicine.disease ,Virology ,Antiretroviral therapy ,CD4 Lymphocyte Count ,3. Good health ,Infectious Diseases ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,HIV-1 ,[SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology ,Female ,Morbidity ,0305 other medical science ,business ,Malaria - Abstract
Background Since antiretroviral therapy (ART), HIV-infected individuals experience mainly non-AIDS-related conditions, among which infectious events are prominent. We aimed to estimate incidence and describe overall spectrum of infectious events, including all grade events, among HIV-1-infected adults failing first-line ART in Yaoundé, Cameroon. Methods All patients from Cameroon enrolled in the second-line ART 2LADY trial (ANRS12169) were included in this secondary analysis. Medical files were reviewed with predefined criteria for diagnosis assessment. Incidence rates (IR) were estimated per 100 person-years (% PY). Results A total of 302 adult patients contributing 840 PY experienced 596 infectious events (IR 71% PY). Only 29 (5%) events were graded as severe. Most frequent infections were upper respiratory tract infections (15% PY), diarrhoea (9% PY) and malaria (9% PY). A total of 369 (62%) infections occurred during the first year (IR 130% PY) followed by a persistent lower incidence during the following 3 years. Higher IR were observed in patients with CD4+ T-cell count ≤200 cells/mm3 for all infectious events except for mycobacterial and parasitic infections. IR of viral, bacterial and parasitic infectious events were lower in case of co-trimoxazole use in patients with CD4+ T-cell count ≤200 cells/mm3. Conclusions Infectious events are common and mainly occur during the first year after treatment initiation. Second-line ART initiation had a positive impact on the entire spectrum of infectious morbidity.
- Published
- 2015
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