Therapeutic status of HIV-infected patients with at least 5 years of follow-up for antiretroviral therapy in a resource-limited setting: the experience of the CNHU ambulatory treatment center in Cotonou, Benin.

Objectives: The aim of this study was to describe the therapeutic situation of patients who had been followed up for antiretroviral therapy for at least 5 years.
Patients and Methods: A retrospective and descriptive study reviewed records of the historical cohort of adults infected with HIV in the national and teaching hospital at Cotonou from January 2, 2002, to March 31, 2013. It included all patients with follow-up for ART for at least five years. Immunological success was defined as a CD4 count above 350 cells/μl at the last test during the study period, and therapeutic success by viral load determined to be undetectable at its last measurement. Data were extracted from the updated ESOPE. STATA 11 software was used for data analysis.
Results: In March 2013, 979 patients, accounting for 27.1% of the overall cohort at the site, had been followed up for at least 5 years for ART. Their mean age was 38.1 ± 9.6 years and the sex-ratio (M/F) was 0.7. Analysis showed that 12.3% had been lost to follow-up, 2.3% had died, and 83.6% remained in treatment. The mean CD4 count at treatment initiation was 113.4±90.7 cells/μl, at 5 years 566.6±355.2 cells/μl, and at 10 years, 557.5±311.2 cells/μl. More than half (56.1%) of patients were treated with a first-line ART combination. Immunological success was reported for 63.2% of the patients. Of the 144 patients with a last viral load available, the therapeutic success rate was 76.4%. The probability of survival was 0.95 at 5 years and 0.91 at 10 years.
Conclusion: Improving the quality and continuity of care can help to ensure short-term survival for PLHIV under a first-line ART treatment in resource-limited countries.