1. Long-term Experience and Outcomes of Programmatic Antiretroviral Therapy for Human Immunodeficiency Virus Type 2 Infection in Senegal, West Africa
- Author
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Binetou Diaw, Mame Demba Sy, Marie Pierre Sy, Jacques F Sambou, Papa Salif Sow, ElHadji Ibrahima Sall, Ibra Ndoye, Khadim Faye, Ibrahima Tito Tamba, Selly Ba, Macoumba Toure, Habibatou D. Agne, Robert W. Coombs, Robert A. Smith, Mouhamadou Baïla Diallo, Geoffrey S. Gottlieb, Louise Fortes, Nancy B. Kiviat, Dominique Faye, Ming Chang, Cheikh Tidiane Ndour, Moussa Seydi, Ndeye Mery Dia Badiane, Stephen E. Hawes, Alassane Niang, Jean Philippe Diatta, Khardiata Diallo, Dana N. Raugi, Jean Jacques Malomar, Ousseynou Cisse, Fatima Sall, and Raphael Bakhoum
- Subjects
0301 basic medicine ,Microbiology (medical) ,Adult ,Pediatrics ,medicine.medical_specialty ,Anti-HIV Agents ,030106 microbiology ,Human immunodeficiency virus (HIV) ,HIV Infections ,Drug resistance ,medicine.disease_cause ,Virus ,West africa ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Antiretroviral Therapy, Highly Active ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,business.industry ,Viral Load ,medicine.disease ,Antiretroviral therapy ,Senegal ,CD4 Lymphocyte Count ,Major Articles and Commentaries ,Africa, Western ,Infectious Diseases ,HIV-2 ,business ,Viral load ,Cohort study - Abstract
Background Programmatic treatment outcome data for people living with human immunodeficiency virus type 2 (HIV-2) in West Africa, where the virus is most prevalent, are scarce. Methods Adults with HIV-2 initiating or receiving antiretroviral therapy (ART) through the Senegalese national AIDS program were invited to participate in this prospective, longitudinal observational cohort study. We analyzed HIV-2 viral loads, CD4 cell counts, antiretroviral drug resistance, loss to follow-up, and mortality. We also examined changes in treatment guidelines over time and assessed progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets for HIV-2. Results We enrolled 291 participants at 2 sites for 926.0 person-years of follow-up over 13 years. Median follow-up time was 2.2 years per participant. There were 21 deaths reported (7.2%), and 117 individuals (40.2%) were lost to follow-up, including 43 (14.7%) who had an initial visit but never returned for follow-up. CD4 counts and HIV-2 viral suppression ( Conclusions Participants in the Senegalese national AIDS program are initiating ART earlier in the course of disease, and more modern therapeutic regimens have improved outcomes among those receiving therapy. Despite these achievements, HIV-2 treatment remains suboptimal, and significant challenges to improving care remain.
- Published
- 2020