Determinants of virological failure in HIV1 infected patients followed in a third-level hospital Abidjan, Cote d’Ivoire

Abstract

: Côte d'Ivoire has been committed to achieving the UNAIDS 90-90-90 targets of People Living with HIV (PLHIV) follow-up since 2015. The proportion of patients on antiretroviral therapy (ART) was below the desired rates for 2020. The laboratory of the University Hospital Center (CHU) of Yopougon has been equipped with instruments capable of quantifying the plasma viral load (VL) of PLHIV on ART. This quantification allowed for early detection of virological failure in PLHIV. The objective of this study was to determine the rate of virological failure and the epidemiological, immunological and virological determinants of virological failure in patients followed at the Yopougon University Hospital in Abidjan. : This was a retrospective study covering the period from January 1, 2015 to October 31, 2019. It was carried out on data related to blood samples (plasma) of PLHIV (infected with HIV-1) under ART for at least 6 months and who had quantified their viral load.: A total of 52356 PLHIV were included in this study. The age group 40-50 years comprised the majority of the patients (46.7%) with a median age of 40 +/- 0.3 years. The female sex predominated with 72% and a sex ratio of (M/F) = 0.38. The TCD4 cell were between 500 and 350 cells/µL in 57.0% of patients at treatment initiation. The TDF+3TC+EFV treatment regimen was prescribed in the majority of patients (88.62%). The population of patients with virological failure (defined as VL ≥ 1000 copies/ml) was 12924 or a prevalence of 24.7%. The determinants of virological failure were age ≤ 15 years, male sex and CD4+ LT rate below 250 cells/µL (p <0.05).: The virological failure rate was high especially in children and male subjects at the Yopougon University Hospital. It appears therefore important to act on these determinants, by additional efforts through concrete actions such as regular and systematic measurement of CV at the time of rapid change of treatments with effective combinations for this type of PLHIV. The goal is to achieve the objectives of the UNAIDS to eradicate HIV by 2030.