Molecular Evaluation of the Efficacy of the TDF+3TC+EFV Therapeutic Regimen in the Treatment of HIV-1 Patients

Background: Antiretroviral therapy (ART) has played an important role in the response to HIV infection and has significantly reduced morbidity and mortality worldwide. It allows control of plasma viral load (CV) to an undetectable level CV<50 copies/ml, an indicator of successful treatment. Assessing the effectiveness of ART makes it possible to make recommendations to limit failures in the treatment of HIV. Thus, the objective of this study is to evaluate the efficacy of the TDF+3TC+EFV therapeutic regimen in the treatment of HIV-1 infection. Materials and methods: This is a retrospective study of the treatment of HIV-1 seropositive patients, at the Molecular Biology Laboratory of HMO in Dakar, Senegal, from 2014 to 2021. The main criterion for evaluating the effectiveness of the treatment was the proportion of patients whose viral load value was undetectable (CV<50 copies/ml) according to the duration of ART. Plasma viral load tests were performed on Abbott Real Time HIV-1® (m2000sp/rt) and COBAS®AmpliPrep/COBAS®TaqMan®(Roche) version 2.0. Variables with p<0.05 were considered statistically significant for all comparisons between groups. Results: Of a cohort of 2,704 HIV+ patients, 2,078 met the inclusion criteria and 626 were excluded due to death, transfer or loss to follow-up. The median age was 38 years, women represented 71% patients. At 6 months of treatment, viral suppression was achieved in 8.9% of men and 6.5% of women (P=0.04) and it was significantly greater in young patients aged 0 to 25 years, 11.4% of patients. 79% of women and 75.2% of men had an undetectable viral load at 12 months of ART (P=0.01). Significantly the suppression was better in men in the first 6 months of treatment, they had more virological success, while women responded better to treatment for a duration of 12 months (P=0.01). At the end of the 18-month study period, 85.5% of patients had a suppressed viral load, 5.3% had a decrease in viral load levels and 7.2% of patients had ...