Estimation of Clinical, Immunological and Virological Failure of First Line Antiretroviral Treatment in Kinshasa, Democratic Republic of Congo

摘要

Background: The prevalence of Human ImmunodeficiencyVirus (HIV) infection was 1.2% in the Democratic Republic of Congo, accordingto the Demographic Health Study report in 2014. In 2012, the severe failurerate to first-line ART in Kinshasa was estimated at more than 16%. Objective: The objective of this study is todetermine the rate of clinical, immunological and virological failure infirst-line treatment, in Kinshasa. Methodology: At the 6th month of Antiretroviral Treatment (ART), 138patients from a follow-up cohort of 8 centers in Kinshasa were received forparaclinical evaluations and analyses. The clinical and paraclinical parameters were recorded on the individualpatient sheets as well as the survey forms. Clinical parameters, viral load andCD4 were evaluated at the 6th month of ART. Results: One hundred and thirty-eight (138) patients had returned forfollow-up treatment, 81 women and 57 men. The average age of patients is 37 ±12 years. The dominant age groups are those of 26 to 35 years and 36 to 45years with 39 patients (28.3%) each, followed by those of 18 to 25 years(21.7%). One hundred and twenty-five (125) patients (90.5%) were in clinicalstage 3 and 13 (9.5%) in clinical stage 4 according to the WHO classification.CD4 levels ranged from 98 to 1050 cells/mm, and a median value of560 cells/mm,. The median value of the patients’ VLs was 0.90 log, copies of RNA/ml with respective minimum and maximum values of 0 and 4.82 log, copies of RNA/ml. The virological failure rate was 24.6%. Conclusions: The rate of virologicalfailure of first-line antiretroviral treatment of patients under treatment inKinshasa is 24.6% for the year 2015.