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. 2019 Feb 26;19(1):194.
doi: 10.1186/s12879-019-3824-7.

Rate of viral load change and adherence of HIV adult patients treated with Efavirenz or Nevirapine antiretroviral regimens at 24 and 48 weeks in Yaoundé, Cameroon: a longitudinal cohort study

Bih Hycenta Chendi  1 , Marie Claire Okomo Assoumou  2 , Graeme Brendon Jacobs  3 , Elsie Laban Yekwa  3 , Emilia Lyonga  2 , Martha Mesembe  2 , Agnes Eyoh  2 , George Mondinde Ikomey  2
Affiliations

Rate of viral load change and adherence of HIV adult patients treated with Efavirenz or Nevirapine antiretroviral regimens at 24 and 48 weeks in Yaoundé, Cameroon: a longitudinal cohort study

Bih Hycenta Chendi et al. BMC Infect Dis. .

Abstract

Background: HIV-load decrease and suppression over time is associated with consistent adherence to antiretroviral therapy (ART). Our study aimed to evaluate the difference in viral load and adherence of patients treated with a combination of either Tenofovir (TDF), Lamivudine (3TC) and Efavirenz (EFV) or TDF / Zidovudine (AZT), 3TC and Nevirapine (NVP) regimens at 24 and 48 weeks.

Methods: A longitudinal study was conducted from May 2016 to June 2017 among 256 HIV infected adult patients who were enrolled at two approved treatment hospitals in Yaoundé, before the start of first-line ART. Whole blood samples were collected using standard operating procedures. HIV-loads were determined by a quantitative RealTime PCR assay. Adherence was evaluated by pharmacy refill data records. Statistical analyses were performed using the PRISM 5.0 software.

Results: Off the 256 HIV infected patients enrolled, 180 (70%) patients completed the study and 76 (30%) patients were lost to follow-up. The success rate in achieving viral load < 40 copies/ml was 1.8 times higher with the EFV regimen at 24 weeks and was 1.2 times higher in the NVP regimen at 48 weeks. At 48 weeks the treatment failure rate was 12.0 and 40.0% in patients on EFV and the NVP regimen, respectively. The rate of adherence varied in both ART based regimens with 84.0 to 74.0% for EFV and 65.5 to 62.5% for NVP, at 24 and 48 weeks respectively.

Conclusion: In our study and setting, the rate of viral load decrease was higher in the NVP based regimen than with the EFV regimen. The adherence rate to ART was higher in the EFV regimen, compared to the NVP regimen. This adds to evidence that the EFV regimen is the preferred ART combination for non-nucleoside reverse transcriptase inhibitors (NNRTIs).

Keywords: Adherence; Efavirenz; HIV infected adult; HIV-load; Nevirapine.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was obtained from the Cameroon National Ethics Committee for Human Health Research with reference number: N°2016/10/829/CE/CNERSH/SP. All participants signed a written consent form.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
HIV-load over time. The Box plot shows the distribution of viral load in copies/ml at baseline, t = 0 before treatment, at 24 weeks (t = 24) and at 48 weeks (t = 48) on ART
Fig. 2
Fig. 2
Difference in viral load. The variation of viral load in both efavirenz (EFV) and nevirapine (NVP) regimens were plotted at baseline, 24 and 48 weeks over time. Each point on the graph represents the mean viral load of patients at a given point in both regimens
Fig. 3
Fig. 3
HIV-load suppression at 24 and 48 weeks. The level of viral load < 40 copies/ml and > 40 copies are represented as undetectable and detectable viral load levels in the chart. Each bar represents the percentage of undetectable and detectable viral load levels in both regimens at 24 and 48 weeks of treatment
Fig. 4
Fig. 4
Adherence and non-adherence to ART regimens at 24 and 48 weeks. The percentage of patients considered adherent and non-adherent at 24 and 48 weeks, are represented in the chart. All patients on the EFV and NVP regimen were considered adherent at 100% at baseline
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References

    1. Pustil R. Global AIDS. Aids. 2016;17(Suppl 4):S3–11. - PubMed
    1. UNAIDS data 2017. Available online at: http://www.unaids.org/sites/default/files/media_asset/20170720_Data_book...
    1. Ministry of Health. National guideline on the prevention and management of HIV in Cameroon, January 2015.
    1. Pefura-YoneEW SE, Kengne AP, Balkissou AD, Kuaban C. Non-adherence to antiretroviral therapy in Yaounde: prevalence, determinants and the concordance of two screening criteria. J Infect Public Health. 2013;6:307–315. doi: 10.1016/j.jiph.2013.02.003. - DOI - PubMed
    1. World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendation for a public health approach. (2016). - PubMed

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