Incidence of Infectious Morbidity Events after Second-Line Antiretroviral Therapy Initiation in HIV-Infected Adults in Yaoundé, Cameroon. Issue 6 (August 2016)

• Record Type: Journal Article
• Authors: Galy, Adrien; Ciaff, Laura; Le Moing, Vincent; Eymard-Duvernay, Sabrina; Abessolo, Hermine; Toby, Roselyne; Ayangma, Liliane; Le Gac, Sylvie; Mpoudi-Etame, Mireille; Koulla-Shiro, Sinata; Delaporte, Eric; Cournil, Amandine
• Is Part Of: Antiviral therapy. Volume 21:Issue 6(2016)
• Page Start: 547
• Page End: 552
• Publication Date: 2016-08
• Subjects: Antiviral agents -- Periodicals; Antiviral Agents -- therapeutic use; Virus Diseases -- therapy; Viruses -- drug effects; Antiviral agents; Periodical; Electronic journals; Periodicals; 616.9106
• DOI: 10.3851/IMP3030
• Languages: English
• ISSNs: 1359-6535

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/mm 3 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/mm 3 . 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.