Immunological Failure at Six Months of Triple Antiretroviral Therapy at Brazzaville University Hospital: Prevalence and Associated Factors

Objective: The objective of this study is to determine the prevalence of immunological failure at six months of antiretroviral therapy in people living with HIV and to identify associated factors. Patient and Method: A descriptive and analytical cross-sectional study covering the period from March to September 2017, including all types of PLWAs who had been under highly active antiretroviral therapy for at least six months and gave their informed consent freely. Results: A total of 325 female patients (n = 249, 76.6%) with an average age of 42 ± 44 years, unemployed (n = 70, 21.5%), low socio-economic status (n = 261, 80.3%), single in 33.8% (n = 110). Patients were in WHO stage IV in 15.4% of cases (n = 50). The average initial CD4 was 235 ± 178.95 cells / mm3. Chronic diarrhoea was the most common opportunistic infection in 98.15% of cases. The most commonly used protocol was TDF + FTC + EFV with 215 patients (66.2%). This average CD4 at six months was 160.02 ± 121.44 cells / mm3, and immunologic failure was reported in 231 patients (71.1%). The occupation (P = 0.001), basic WHO stage (P < 0.001), the duration of serologic status (P = 0.001), tuberculosis (P = 0.001) were statistically significant with the occurrence of failure and there was a correlation between the initial CD4 rate and that at 6 months. Conclusion: Our study demonstrates that the prevalence of immunologic failure remains high in relation to low socioeconomic status, screening and late management of HIV infection in addition to opportunistic infection.