Viral suppression in the context of SARS-CoV-2 among children infected with HIV-1 monitored in five health facilities in Benin.

IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES
Edwige Hermione Dagba Gbessin, Michel Kiréopori Gomgnimbou, René Kpemahouton Keke, Haziz Sina, Aldric Afangnihoun, Moussa Bachabi, Abdoul-Salam Ouedraogo, Lamine Baba-Moussa
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引用次数: 0

Abstract

Monitoring the effectiveness of antiretroviral treatment by measuring viral load is a strong recommendation from the WHO following the intensification of this therapy, which, if well managed, improves patients' quality of life. In children, treatment options are limited and virological non-suppression is high. Virological suppression among children living with HIV who were followed at care facilities during the SARS-CoV-2 pandemic is poorly documented in countries with intermediate resources, such as Benin. Methods A longitudinal study was carried out from November 20, 2020, among children under 15 years of age who had been receiving ART for at least six months in five healthcare facilities. TCD4 lymphocytes (LTCD4) count was performed using the CyFlow counter II (from Partec laboratories). Viral load was performed using the Abbott RealTime HIV-1 assay (Abbott Molecular, Inc.). The linear range of 40-10.000.000 copies/ml and a detection limit of 40 copies/ml were defined by the manufacturers. Virological success was assessed as a suppressed viral load (VL < 3log10). For children whose VL1 ≥ 3log10, WHO 2016 recommendations were applied and therapeutic education sessions were offered for 3 months, after which VL2 was measured. Children whose (VL1 and VL2) ≥ 3log10 were considered not suppressed. Results The mean age of 305 children enrolled was 110 (SD 41.25) months, with a predominance of girls at 52.8% (161/305). The median LTCD4 at study starting was 814 [IQR 544-1118] cells/µl. Overall, 73.11% (223/305) of children achieved virological success at the first viral load measurement, compared to 79.63% (219/275) at the second (03 months after the first). Between the two measurements, 9.83% (30/305) of children did not keep their medical appointments due to SARS-CoV-2 pandemic restrictions. Also, 20.73% (17/82) of non-suppressed children at VL1 went undetectable. Among the 17.1% (47/275) of unsuppressed children, 10.64% (5/47) were on integrase strand transfer inhibitors as DTG (Dolutegravir). Conclusion This study, conducted in children on ART during the SARS-CoV-2 pandemic, highlighted a high rate of retention in care and viral suppression. However, there are challenges in achieving the UNAIDS third 95 to ensure sustainable viral suppression in children.

在贝宁的五个卫生机构监测感染艾滋病毒-1的儿童中SARS-CoV-2病毒的抑制情况。
世卫组织强烈建议在加强抗逆转录病毒治疗后,通过测量病毒载量来监测抗逆转录病毒治疗的有效性,如果管理得当,可改善患者的生活质量。在儿童中,治疗选择有限,病毒学上的不抑制性很高。在资源中等的国家,如贝宁,在SARS-CoV-2大流行期间在护理机构随访的艾滋病毒感染儿童的病毒学抑制记录很少。方法自2020年11月20日起,对在5家医疗机构接受抗逆转录病毒治疗至少6个月的15岁以下儿童进行了一项纵向研究。TCD4淋巴细胞(LTCD4)计数使用CyFlow计数器II(来自Partec实验室)。病毒载量检测采用Abbott RealTime HIV-1检测(Abbott Molecular, Inc.)。检测限为40 ~ 10.000.000 copies/ml,检测限为40 copies/ml。通过抑制病毒载量(vl10)来评估病毒学上的成功。对于VL1≥3log10的儿童,采用WHO 2016建议,并进行为期3个月的治疗性教育,之后测量VL2。(VL1和VL2)≥3log10的儿童被认为没有抑制。结果305例患儿的平均年龄为110 (SD 41.25)个月,女孩占52.8%(161/305)。研究开始时中位LTCD4为814 [IQR 544-1118]个细胞/µl。总体而言,73.11%(223/305)的儿童在第一次病毒载量测量时获得病毒学成功,而第二次(第一次后03个月)的病毒学成功为79.63%(219/275)。在这两次测量中,9.83%(30/305)的儿童由于SARS-CoV-2大流行的限制而没有按时就诊。此外,20.73%(17/82)的VL1非抑制儿童未被检测到。在17.1%(47/275)未受抑制的儿童中,10.64%(5/47)使用整合酶链转移抑制剂如DTG (Dolutegravir)。该研究在SARS-CoV-2大流行期间对接受抗逆转录病毒治疗的儿童进行了研究,强调了治疗的高保留率和病毒抑制。然而,在实现艾滋病规划署第三个目标以确保在儿童中持续抑制病毒方面存在挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Infectious Diseases
BMC Infectious Diseases 医学-传染病学
CiteScore
6.50
自引率
0.00%
发文量
860
审稿时长
3.3 months
期刊介绍: BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.
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