Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model

doi:10.3390/v15010018

. 2022 Dec 21;15(1):18.

doi: 10.3390/v15010018.

Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model

Ezechiel Ngoufack Jagni Semengue^{1

2

3}, Joseph Fokam^{1

4

5}, Naomi-Karell Etame^{1

6}, Evariste Molimbou^{1

3}, Collins Ambe Chenwi¹, Désiré Takou¹, Leonella Mossiang⁷, Alain P Meledie⁸, Bouba Yagai^{1

2}, Alex Durand Nka^{1

2

3}, Beatrice Dambaya¹, Georges Teto¹, Aude Christelle Ka'e^{1

9}, Grâce Angong Beloumou¹, Sandrine Claire Djupsa Ndjeyep¹, Aissatou Abba¹, Aurelie Minelle Ngueko Kengni^{1

6}, Michel Carlos Tommo Tchouaket^{1

6}, Nounouce Pamen Bouba¹⁰, Serge-Clotaire Billong^{11

12}, Samuel Martin Sosso¹, Vittorio Colizzi^{2

3}, Carlo-Federico Perno¹³, Charles Kouanfack^{6

14}, Anne-Cecile Zoung-Kanyi Bissek^{12

15}, Emmanuel Eben-Moussi¹, Maria Mercedes Santoro², Francesca Ceccherini-Silberstein^{2

9}, Alexis Ndjolo^{1

12}

Affiliations

¹ Chantal BIYA International Reference Centre for Research on HIV/AIDS Management and Care, Messa, Yaoundé P.O. Box 3077, Cameroon.
² Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
³ Faculty of Sciences and Technologies, Evangelical University of Cameroon, Bandjoun P.O. Box 0127, Cameroon.
⁴ Faculty of Health Sciences, University of Buea, Buea P.O. Box 063, Cameroon.
⁵ National HIV Drug Resistance Working Group, Ministry of Public Health, Yaoundé III P.O. Box 3038, Cameroon.
⁶ School of Health Sciences, Catholic University of Central Africa, Yaoundé P.O. Box 11628, Cameroon.
⁷ Central Hospital of Yaoundé, Yaoundé P.O. Box 047, Cameroon.
⁸ General Hospital of Douala, Douala P.O. Box 4856, Cameroon.
⁹ PhD Courses in Microbiology, Immunology, Infectious Diseases and Transplants (MIMIT), University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
¹⁰ Directorate for Disease Epidemic and Pandemic Control, Ministry of Public Health, Yaoundé III P.O. Box 3038, Cameroon.
¹¹ Central Technical Group, National AIDS Control Committee, Yaoundé II P.O. Box 2005, Cameroon.
¹² Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon.
¹³ Bambino Gesu' Children's Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy.
¹⁴ Faculty of Medicine and Pharmaceutical Sciences, University de Dschang, Dschang P.O. Box 067, Cameroon.
¹⁵ Division of Operational Health Research, Ministry of Public Health, Yaoundé III P.O. Box 3038, Cameroon.

PMID: 36680058
PMCID: PMC9866637
DOI: 10.3390/v15010018

Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model

Ezechiel Ngoufack Jagni Semengue et al. Viruses. 2022.

. 2022 Dec 21;15(1):18.

doi: 10.3390/v15010018.

Authors

Affiliations

¹ Chantal BIYA International Reference Centre for Research on HIV/AIDS Management and Care, Messa, Yaoundé P.O. Box 3077, Cameroon.
² Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
³ Faculty of Sciences and Technologies, Evangelical University of Cameroon, Bandjoun P.O. Box 0127, Cameroon.
⁴ Faculty of Health Sciences, University of Buea, Buea P.O. Box 063, Cameroon.
⁵ National HIV Drug Resistance Working Group, Ministry of Public Health, Yaoundé III P.O. Box 3038, Cameroon.
⁶ School of Health Sciences, Catholic University of Central Africa, Yaoundé P.O. Box 11628, Cameroon.
⁷ Central Hospital of Yaoundé, Yaoundé P.O. Box 047, Cameroon.
⁸ General Hospital of Douala, Douala P.O. Box 4856, Cameroon.
⁹ PhD Courses in Microbiology, Immunology, Infectious Diseases and Transplants (MIMIT), University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
¹⁰ Directorate for Disease Epidemic and Pandemic Control, Ministry of Public Health, Yaoundé III P.O. Box 3038, Cameroon.
¹¹ Central Technical Group, National AIDS Control Committee, Yaoundé II P.O. Box 2005, Cameroon.
¹² Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon.
¹³ Bambino Gesu' Children's Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy.
¹⁴ Faculty of Medicine and Pharmaceutical Sciences, University de Dschang, Dschang P.O. Box 067, Cameroon.
¹⁵ Division of Operational Health Research, Ministry of Public Health, Yaoundé III P.O. Box 3038, Cameroon.

PMID: 36680058
PMCID: PMC9866637
DOI: 10.3390/v15010018

Abstract

To ensure optimal prescribing practices in the dolutegravir-era in Cameroon, we compared first-line virological response (VR) under tenofovir + lamivudine + dolutegravir (TLD) according to prior exposure to tenofovir + lamivudine + efavirenz (TLE). A facility-based survey was conducted among patients initiating antiretroviral therapy (ART) with TLD (I-TLD) versus those transitioning from TLE to TLD (T-TLD). HIV viral load was performed and unsuppressed participants (VL > 1000 copies/mL) had genotyping performed by Sanger sequencing. Of the 12,093 patients followed, 310 (mean-age: 41 ± 11 years; 52.26% female) complied with study criteria (171 I-TLD vs. 139 T-TLD). The median ART-duration was 14 (12−17) months among I-TLDs versus 28 (24.5−31) months among T-TLDs (15 (11−19) on TLE and 14 (9−15) on TLD), and 83.15% (148/178) were at WHO clinical stages I/II. The viral suppression rate (<1000 copies/mL) was 96.45%, with 97.08% among I-TLDs versus 95.68% among T-TLDs (p = 0.55). VR was similar in I-TLD versus T-TLD at <400 copies/mL (94.15% versus 94.42%) and age, gender, residence, ART-duration, and WHO stages were not associated with VR (p > 0.05). Genotyping was successful for 72.7% (8/11), with no major mutations to integrase inhibitors found. VR is optimal under first-line TLD after 14 months, even among TLE-exposed, thus confirming the effectiveness of transitioning from TLE to TLD in similar settings, supported by strong pharmacological potency and genetic barrier of dolutegravir.

Keywords: Cameroon; HIV; TLD; antiretrovirals; first-line; virological response.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Flow chart of patients’ enrolment and follow-up in the study population. Legend. Bold represents subtitles.

**Figure 2**
Virological response under TLD in first-line treatment among participants.

See this image and copyright information in PMC

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References

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[1] NIH-National Institute of Health Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV. [(accessed on 28 May 2022)]; Available online: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult....

[2] NIH-National Institute of Health Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV. [(accessed on 28 May 2022)]; Available online: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult....

[3] MINSANTE . Guide National De Prise En Charge Des Personnes Vivant Avec Le VIH/SIDA-Cameroun. Ministère de la Santé Publique; Yaoundé, Cameroun: 2012.

[4] MINSANTE . Guide National De Prise En Charge Des Personnes Vivant Avec Le VIH/SIDA-Cameroun. Ministère de la Santé Publique; Yaoundé, Cameroun: 2012.

[5] MINSANTE . Plan National Multisectoriel De Lutte Contre Le Vih, Le Sida Et Les Ist (Pnm) Annee 2014–2017. Ministère de la Santé Publique; Yaoundé, Cameroun: 2013. pp. 1–163.

[6] MINSANTE . Plan National Multisectoriel De Lutte Contre Le Vih, Le Sida Et Les Ist (Pnm) Annee 2014–2017. Ministère de la Santé Publique; Yaoundé, Cameroun: 2013. pp. 1–163.

[7] MINSANTE . Directives Nationales De Prevention. Ministère de la Santé Publique; Yaoundé, Cameroun: 2014. p. 193.

[8] MINSANTE . Directives Nationales De Prevention. Ministère de la Santé Publique; Yaoundé, Cameroun: 2014. p. 193.

[9] WHO . Lignes Directrices Unifiées Sur l’utilisation Des Antirétroviraux Pour Le Traitement et La Prévention De l’infection à VIH: Recommandations Pour Une Approche De Santé Publique. World Health Organization; Geneve, Switzerland: 2013. [(accessed on 2 March 2022)]. Available online: https://apps.who.int/iris/handle/10665/101196.

[10] WHO . Lignes Directrices Unifiées Sur l’utilisation Des Antirétroviraux Pour Le Traitement et La Prévention De l’infection à VIH: Recommandations Pour Une Approche De Santé Publique. World Health Organization; Geneve, Switzerland: 2013. [(accessed on 2 March 2022)]. Available online: https://apps.who.int/iris/handle/10665/101196.

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Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model

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Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model

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