Objective: The purpose of this study was to determine the prevalence of antiretroviral therapy failure and to identify factors associated with failure in HIV infected patients on antiretroviral therapy. Methods: A six years retrospective cohort study was conducted. All HIV- infected patients on antiretroviral therapy for at least 12 months and followed in the outpatient treatment center at the CNHU-HKM in Cotonou were systematically included. The evaluation of the failure was clinical and immunological using the WHO 2010 criteria adapted by the Beninese national HIV/AIDS program. Data was extracted from ESOPE database and analyzed by SPSS 10.0. Multivariable linear regression was performed to identify predictors of antiretroviral treatment failure and p < 0.05 was considered to declare a statistical significance. Results: A total of 268 HIV infected patients were enrolled in the study. The overall prevalence of antiretroviral treatment failure was 35.4% (n=95), including thirty-one cases of clinical failure (11.6%), ten cases of immunological failure (6.3%) and forty-seven cases of clinico-immunological failure (17.5%). The mean age was 37 ± 22 years and the sex ratio was 0.71. Non-adherence to treatment was found to be the main cause of HARRT failure in 71.6% of cases (n=68). High levels of education, polygamy, advanced clinical stage (WHO stage IV) and a history of documented adverse effects were predictors of antiretroviral therapy failure. Difficulties in accessing routine viral loads and second-line molecules did not allow for early diagnosis and good management of HAART failure in Benin. Conclusion: The prevalence of clinical and immunological failure is high in this cohort. It is necessary to facilitate access to routine viral load as the main means of HAART monitoring and to make second-line molecules available.
| Published in | International Journal of Infectious Diseases and Therapy (Volume 2, Issue 3) |
| DOI | 10.11648/j.ijidt.20170203.12 |
| Page(s) | 53-58 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2017. Published by Science Publishing Group |
Failure, Antiretroviral Therapy, Predictors, Benin, West-Africa
| [1] | Broder S. The development of antiretroviral therapy and its impact on the HIV-1/AIDS pandemic. Antiviral Res. 2010; 85 (1): doi: 10.1016. |
| [2] | Pavie J, Molina JM. Treatment of the human immunodeficiency virus in adults in 2005; Presse med. 2005; 34 (10): 38-44. |
| [3] | Taverne, B., Desclaux, A., Sow, P. S., Delaporte, E., Ndoye, I. Evaluation de l’impact bioclinique et social, individuel et collectif, du traitement ARV chez des patients VIH-1 pris en charge depuis 10 ans dans le cadre de l’ISAARV – Cohorte ANRS 1215. Rapport final, mai 2012. Dakar. CNLS, CRCF, IRD, ANRS, 2012, 415 p. |
| [4] | Johnson LF, Mossong J, Dorrington RE, Schomaker M, Hoffmann CJ, Keiser O, Fox MP et al. Life expectancies of South African adults starting antiretroviral treatment: collaborative analysis of cohort studies. PLoS Med, 2013, 10 (4): e1001418. |
| [5] | Montaner JSG, Lima VD, Harrigan PR, Lourenc¸o L, Yip B, Nosyk B, et al. (2014) Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: the ‘‘HIV treatment as prevention’’ experience in a Canadian setting. PLoS One 9 (2): e87872. doi: 10.1371 |
| [6] | Bor J, Herbst AJ, Newell M-L et Bärnighausen T. Increases in adult life expectancy in rural South Africa: valuing the scale-up of HIV treatment. Science. 2013; 339 (6122): doi: 10.1126. |
| [7] | Caroline A Sabin. Do people with HIV infection have a normal life expectancy in the era of combination antiretroviral therapy? BMC Medicine 2013, 11: 251. |
| [8] | Hart JE, Jeon CY, Ivers LC, Behforouz HL, Caldas A, Drobac PC, Shin SS. Effect of directly observed therapy for highly active antiretroviral therapy on virologic, immunologic, and adherence outcomes: a meta-analysis and systematic review. J Acquir Immune Defic Syndr. 2010; 54 (2): 167–79. |
| [9] | Li X, Margolick J, B MD, Jamieson B, Rinaldo C, Phair J, Jacobson L. CD4+ T-cell counts and plasma HIV-1 RNA levels beyond 5 years of highly active antiretroviral therapy (HAART). J Acquir Immune Defic Syndr. 2011; 57 (5): 421–28. |
| [10] | Marconi VC, Grandits GA, Weintrob AC, Chun H, Landrum ML, Ganesan A, Okulicz JF, Crum-Cianflone N, O'Connell RJ, Lifson A, Wortmann GW, Agan BK et al., Outcomes of highly active antiretroviral therapy in the context of universal access to healthcare: the U. S. Military HIV natural history study. AIDS Research and Therapy 2010, 7: 14 doi: 10.1186. |
| [11] | Iroezindu MO. Disparities in the magnitude of human immunodeficiency virus-related opportunistic infections between high and low/middle-income countries: is highly active antiretroviral therapy changing the trend? Ann Med Health Sci Res. 2016; 6 (1): 4–18. |
| [12] | Boender TS, Sigaloff KCE, McMahon JH, Kiertiburanakul S, Jordan MR, Barcarolo J, Ford N, Rinke de Wit TF, Bertagnolio S. Long-term virological outcomes of first-line antiretroviral therapy for hiv-1 in low and middle-income countries: a systematic review and meta-analysis. Clin Infect Dis. 2015; 61 (9): 1453– 61. |
| [13] | Johnston V, Fielding KL, Charalambous S, Churchyard G, Phillips A, Grant AD. Outcomes following virological failure and predictors of switching to second-line antiretroviral therapy in a South African treatment programme. J Acquir Immune Defic Syndr. 2012; 61 (3): doi: 10.1097 |
| [14] | Gupta-Wright A, Wood R, Bekker L-G, Lawn SD. Temporal association between incident tuberculosis and poor virological outcomes in a South African antiretroviral treatment service. J Acquir Immune Defic Syndr. 2013; 64 (3): 261–70. |
| [15] | Aghokeng AF, Kouanfack C, Eymard-Duvernay S, Butel C, Edoul GE, Laurent C, Koulla-Shiro S, Delaporte E, Mpoudi-Ngole E, Peeters M. Virological outcome and patterns of HIV-1 drug resistance in patients with 36 months’ antiretroviral therapy experience in Cameroon. Journal of the International AIDS Society 2013, 16: 18004. |
| [16] | ONUSIDA. 90-90-90. Une cible ambitieuse de traitement pour aider à mettre fin à l’épidémie du sida. Programme Conjoint des Nations Unies sur le VIH/SIDA 2015. 33p. |
| [17] | Vanobberghen FM, Kilama B, Wringe A, Ramadhani A, Zaba B, Mmbando D, Todd J. Immunological failure of first-line and switch to second-line antiretroviral therapy among HIV-infected persons in Tanzania: analysis of routinely collected national data. Trop Med Int Health. 2015; 20 (7): 880–92. |
| [18] | Ahoua L, Guenther G, Pinoges L, Anguzu P, Chaix M-L, Le Tiec C, Balkan S, Olson D, Olaro C, Pujades-Rodríguez M. Risk factors for virological failure and subtherapeutic antiretroviral drug concentrations in HIV-positive adults treated in rural northwestern Uganda. BMC Infect Dis. 2009; 9: 81. doi: 10.1186. |
| [19] | Haas AD, Keiser O, Balestre E, Brown S, Bissagnene E, Chimbetete C, Dabis F, Davies M-A, Hoffmann CJ, Oyaro P, Parkes-Ratanshi R, Reynolds SJ, Sikazwe I, Wools-Kaloustian K, Zannou DM, Wandeler G, Egger M. Monitoring and switching of first-line antiretroviral therapy in Sub-Saharan Africa: collaborative analysis of adult treatment cohorts. Lancet HIV. 2015; 2 (7): e271–e278. |
| [20] | Estill J, Salazar-Vizcaya L, Blaser N, Egger M, Keiser O. The cost-effectiveness of monitoring strategies for antiretroviral therapy of HIV infected patients in resource-limited settings: software tool. PLoS One. 2015; 10 (3): e0119299. |
| [21] | Huang P, Tan J, Ma W, Zheng H, Lu Y, Wang N, Peng Z, Yu R. Outcomes of antiretroviral treatment in HIV-infected adults: a dynamic and observational cohort study in Shenzhen, China, 2003–2014. BMJ Open. 2015; 5 (5): e007508. |
| [22] | Ingole N, Mehta P, Pazare A, Paranjpe S, Sarkate P. Performance of immunological response in predicting virological failure. AIDS Res Hum Retroviruses. 2013 Mar; 29 (3): 541–46. |
| [23] | Ramadhani HO, Bartlett JA, Thielman NM, Pence BW, Kimani SM, Maro VP, Mwako MS, Masaki LJ, Mmbando CE, Minja MG, Lirhunde ES, Miller WC. The Effect of switching to second-line antiretroviral therapy on the risk of opportunistic infections among patients infected with human immunodeficiency virus in Northern Tanzania. Open Forum Infect Dis. 2016; 3 (1): of w018. |
| [24] | Nichols BE, Sigaloff KCE, Kityo C, Hamers RL, Baltussen R, Bertagnolio S, Jordan MR, Hallett TB, Boucher CAB, Rinke de Wit TF, van de Vijver DAMC. Increasing the use of second-line therapy is a cost-effective approach to prevent the spread of drug-resistant HIV: a mathematical modelling study. J Int AIDS Soc. 2014; 17 (1): 19164. doi: 10.7448. |
| [25] | Motasim Badri, Stephen D Lawn, Robin Wood. Utility of CD4 cell counts for early prediction of virological failure during antiretroviral therapy in a resource-limited setting. BMC Infect Dis. 2008; 8: 89. doi: 10.1186. |
| [26] | Tetteh RA, Nartey ET, Lartey M, Mantel-Teeuwisse AK, Leufkens HGM, Yankey BA, Dodoo ANO. Association between the occurrence of adverse drug events and modification of first-line highly active antiretroviral therapy in Ghanaian HIV patients. Drug Saf. 2016; 39 (11): 1139–49. |
| [27] | Zoufaly A, an der Heiden M, Kollan C, Bogner JR, Fätkenheuer G, Wasmuth JC, Stoll M, Hamouda O, van Lunzen J. Clinical outcome of hiv-infected patients with discordant virological and immunological response to antiretroviral therapy. J Infect Dis. 2011; 203 (3): 364–71. |
| [28] | Ferreyra C, Yun O, Eisenberg N, Alonso E, Khamadi AS, Mwau M, Mugendi MK, Alvarez A, Velilla E, Flevaud L, Arnedo M, Dalmau D, Roddy P, Bernasconi A, Palma PP. Evaluation of Clinical and Immunological Markers for Predicting Virological Failure in a HIV/AIDS Treatment Cohort in Busia, Kenya PLoS One. 2012; 7 (11): e49834. |
| [29] | Kityo C, Gibb DM, Gilks CF, Goodall RL, Mambule I, Kaleebu P, Pillay D, Kasirye R, Mugyenyi P, Walker AS, Dunn DT. High level of viral suppression and low switch rate to second-line antiretroviral therapy among HIV-infected adult patients followed over five years: retrospective analysis of the DART trial. PLoS One. 2014; 9 (3): e90772. |
| [30] | Programme National de Lutte contre le SIDA (PNLS), Bénin. Politique, normes et procédures pour la prise en charge des personnes vivant avec le VIH au Bénin. PNLS - Bénin, 2010. |
| [31] | Yirdaw KD, Hattingh S. Prevalence and Predictors of Immunological Failure among HIV Patients on HAART in Southern Ethiopia. PLoS One 2015; 10 (5): e0125826. |
APA Style
Cossi Angelo Attinsounon, Kouessi Anthelme Agbodandé, Angèle Azon-Kouanou, Ezin Jocelyn Akakpo, Djimon Marcel Zannou. (2017). Prevalence and Predictors of Clinical and Immunological Failure among Adults HIV Patients on HAART in Southern Benin. International Journal of Infectious Diseases and Therapy, 2(3), 53-58. https://doi.org/10.11648/j.ijidt.20170203.12
ACS Style
Cossi Angelo Attinsounon; Kouessi Anthelme Agbodandé; Angèle Azon-Kouanou; Ezin Jocelyn Akakpo; Djimon Marcel Zannou. Prevalence and Predictors of Clinical and Immunological Failure among Adults HIV Patients on HAART in Southern Benin. Int. J. Infect. Dis. Ther. 2017, 2(3), 53-58. doi: 10.11648/j.ijidt.20170203.12
AMA Style
Cossi Angelo Attinsounon, Kouessi Anthelme Agbodandé, Angèle Azon-Kouanou, Ezin Jocelyn Akakpo, Djimon Marcel Zannou. Prevalence and Predictors of Clinical and Immunological Failure among Adults HIV Patients on HAART in Southern Benin. Int J Infect Dis Ther. 2017;2(3):53-58. doi: 10.11648/j.ijidt.20170203.12
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ijidt.20170203.12,
author = {Cossi Angelo Attinsounon and Kouessi Anthelme Agbodandé and Angèle Azon-Kouanou and Ezin Jocelyn Akakpo and Djimon Marcel Zannou},
title = {Prevalence and Predictors of Clinical and Immunological Failure among Adults HIV Patients on HAART in Southern Benin},
journal = {International Journal of Infectious Diseases and Therapy},
volume = {2},
number = {3},
pages = {53-58},
doi = {10.11648/j.ijidt.20170203.12},
url = {https://doi.org/10.11648/j.ijidt.20170203.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20170203.12},
abstract = {Objective: The purpose of this study was to determine the prevalence of antiretroviral therapy failure and to identify factors associated with failure in HIV infected patients on antiretroviral therapy. Methods: A six years retrospective cohort study was conducted. All HIV- infected patients on antiretroviral therapy for at least 12 months and followed in the outpatient treatment center at the CNHU-HKM in Cotonou were systematically included. The evaluation of the failure was clinical and immunological using the WHO 2010 criteria adapted by the Beninese national HIV/AIDS program. Data was extracted from ESOPE database and analyzed by SPSS 10.0. Multivariable linear regression was performed to identify predictors of antiretroviral treatment failure and p < 0.05 was considered to declare a statistical significance. Results: A total of 268 HIV infected patients were enrolled in the study. The overall prevalence of antiretroviral treatment failure was 35.4% (n=95), including thirty-one cases of clinical failure (11.6%), ten cases of immunological failure (6.3%) and forty-seven cases of clinico-immunological failure (17.5%). The mean age was 37 ± 22 years and the sex ratio was 0.71. Non-adherence to treatment was found to be the main cause of HARRT failure in 71.6% of cases (n=68). High levels of education, polygamy, advanced clinical stage (WHO stage IV) and a history of documented adverse effects were predictors of antiretroviral therapy failure. Difficulties in accessing routine viral loads and second-line molecules did not allow for early diagnosis and good management of HAART failure in Benin. Conclusion: The prevalence of clinical and immunological failure is high in this cohort. It is necessary to facilitate access to routine viral load as the main means of HAART monitoring and to make second-line molecules available.},
year = {2017}
}
TY - JOUR T1 - Prevalence and Predictors of Clinical and Immunological Failure among Adults HIV Patients on HAART in Southern Benin AU - Cossi Angelo Attinsounon AU - Kouessi Anthelme Agbodandé AU - Angèle Azon-Kouanou AU - Ezin Jocelyn Akakpo AU - Djimon Marcel Zannou Y1 - 2017/04/12 PY - 2017 N1 - https://doi.org/10.11648/j.ijidt.20170203.12 DO - 10.11648/j.ijidt.20170203.12 T2 - International Journal of Infectious Diseases and Therapy JF - International Journal of Infectious Diseases and Therapy JO - International Journal of Infectious Diseases and Therapy SP - 53 EP - 58 PB - Science Publishing Group SN - 2578-966X UR - https://doi.org/10.11648/j.ijidt.20170203.12 AB - Objective: The purpose of this study was to determine the prevalence of antiretroviral therapy failure and to identify factors associated with failure in HIV infected patients on antiretroviral therapy. Methods: A six years retrospective cohort study was conducted. All HIV- infected patients on antiretroviral therapy for at least 12 months and followed in the outpatient treatment center at the CNHU-HKM in Cotonou were systematically included. The evaluation of the failure was clinical and immunological using the WHO 2010 criteria adapted by the Beninese national HIV/AIDS program. Data was extracted from ESOPE database and analyzed by SPSS 10.0. Multivariable linear regression was performed to identify predictors of antiretroviral treatment failure and p < 0.05 was considered to declare a statistical significance. Results: A total of 268 HIV infected patients were enrolled in the study. The overall prevalence of antiretroviral treatment failure was 35.4% (n=95), including thirty-one cases of clinical failure (11.6%), ten cases of immunological failure (6.3%) and forty-seven cases of clinico-immunological failure (17.5%). The mean age was 37 ± 22 years and the sex ratio was 0.71. Non-adherence to treatment was found to be the main cause of HARRT failure in 71.6% of cases (n=68). High levels of education, polygamy, advanced clinical stage (WHO stage IV) and a history of documented adverse effects were predictors of antiretroviral therapy failure. Difficulties in accessing routine viral loads and second-line molecules did not allow for early diagnosis and good management of HAART failure in Benin. Conclusion: The prevalence of clinical and immunological failure is high in this cohort. It is necessary to facilitate access to routine viral load as the main means of HAART monitoring and to make second-line molecules available. VL - 2 IS - 3 ER -
Information
Email: