Slow virologic control but strong immune and metabolic recovery with dolutegravir-anchored therapy in an HIV cohort in Ghana
Abstract Introduction The West African HIV/AIDS epidemic, historically driven by HIV-1 CRF02_AG, other recombinant forms and HIV-2, remains less researched for various preventive and therapeutic interventions. We established the WACCBIP long-term HIV Infection Cohort (WHICH Study) to investigate the...
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BMC
2025-07-01
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| Series: | Virology Journal |
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| Online Access: | https://doi.org/10.1186/s12985-025-02873-w |
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| author | Mark Appeaning Edwin Magomere Alberta Mawulawoe Abotsi Nana Ama Yeboaa Amoako Kirk Elorm Kouffie Becky Ewurama Tetteh Bridget Nana Darkoa Quist Christèle Nguepou Tchopba Gloria Akosua Ansa Evelyn Yayra Bonney Peter Kojo Quashie |
| author_facet | Mark Appeaning Edwin Magomere Alberta Mawulawoe Abotsi Nana Ama Yeboaa Amoako Kirk Elorm Kouffie Becky Ewurama Tetteh Bridget Nana Darkoa Quist Christèle Nguepou Tchopba Gloria Akosua Ansa Evelyn Yayra Bonney Peter Kojo Quashie |
| author_sort | Mark Appeaning |
| collection | DOAJ |
| description | Abstract Introduction The West African HIV/AIDS epidemic, historically driven by HIV-1 CRF02_AG, other recombinant forms and HIV-2, remains less researched for various preventive and therapeutic interventions. We established the WACCBIP long-term HIV Infection Cohort (WHICH Study) to investigate the dynamics of HIV epidemic in Ghana. This report evaluates viral load dynamics, immune responses, and organ-level metabolic changes following antiretroviral therapy (ART) initiation. Method We collected blood samples, medical, and demographic data from ART-naïve individuals at baseline and six months post-ART, and from ART-experienced individuals at a single time point. Participants, aged 10 years and above, were purposively enrolled from six health facilities. Laboratory analyses included viral load, CD4 and CD8 counts, co-infection screening (hepatitis B/C, syphilis), liver and kidney function tests, haemoglobin estimation, and HIV-1/2 typing. Chi-square and logistic regression analyses were used to assess associations between participant demographics and clinical data with uncontrolled viremia and immune recovery. Results A total of 426 participants were recruited, comprising 159 ART-naïve and 267 ART-experienced individuals, with a mean age of 41.5 years. Median ART duration for ART-experienced was greater than 5 years. Infections included HIV-1 (78.6%), HIV-2 (2.1%), and dual HIV-1&2 (19.2%). Common comorbidities were anaemia (54.9%), hepatitis B (9.5%), and hypertension (8.2%). Most participant (97.9%) were on dolutegravir-anchored regimen. Among ART-naïve individuals, median viral load decreased from log10 5.16 at baseline to log10 4.64 copies/mL after six months (p = 0.0156). Median viral load for the ART-experienced arm was log10 3.23 copies/mL. Median CD4 count increased from 290 cells/mm³ in ART-naïve participants to 504 cells/mm³ at six-months post-ART (p = 0.0003) and 581 cells/mm³ in ART-experienced participants (p < 0.0001). ART-naïve participants were 19 times more likely to have unsuppressed viral loads at baseline compared to ART-experienced participants. ARTnaïve- participants had significantly decreased odds of immune recovery (aOR = 0.35, 95% CI: 0.140–0.85, p = 0.021), as did those with low CD4/CD8 ratio (aOR = 0.06, 95% CI: 0.02–0.20; p < 0.001). Kidney function and haemoglobin levels were significantly improved six-month post-ART among the ART-naïve group. Conclusion This study highlights the significant reduction in viral load and improved immune recovery following ART initiation despite uncontrolled viremia in a subset of participants. This cohort presents an opportunity to study Ghana’s local HIV epidemic, including HIV-1 and HIV-2, and impact of ART on disease progression. |
| format | Article |
| id | doaj-art-1c8f866d21c94b478fbb616d8cdd07bd |
| institution | Kabale University |
| issn | 1743-422X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Virology Journal |
| spelling | doaj-art-1c8f866d21c94b478fbb616d8cdd07bd2025-08-20T03:42:34ZengBMCVirology Journal1743-422X2025-07-0122111410.1186/s12985-025-02873-wSlow virologic control but strong immune and metabolic recovery with dolutegravir-anchored therapy in an HIV cohort in GhanaMark Appeaning0Edwin Magomere1Alberta Mawulawoe Abotsi2Nana Ama Yeboaa Amoako3Kirk Elorm Kouffie4Becky Ewurama Tetteh5Bridget Nana Darkoa Quist6Christèle Nguepou Tchopba7Gloria Akosua Ansa8Evelyn Yayra Bonney9Peter Kojo Quashie10West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of GhanaWest African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of GhanaWest African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of GhanaWest African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of GhanaWest African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of GhanaWest African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of GhanaWest African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of GhanaWest African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of GhanaPublic Health Department, University of Ghana Health ServicesNoguchi Memorial Institute for Medical Research, University of GhanaWest African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of GhanaAbstract Introduction The West African HIV/AIDS epidemic, historically driven by HIV-1 CRF02_AG, other recombinant forms and HIV-2, remains less researched for various preventive and therapeutic interventions. We established the WACCBIP long-term HIV Infection Cohort (WHICH Study) to investigate the dynamics of HIV epidemic in Ghana. This report evaluates viral load dynamics, immune responses, and organ-level metabolic changes following antiretroviral therapy (ART) initiation. Method We collected blood samples, medical, and demographic data from ART-naïve individuals at baseline and six months post-ART, and from ART-experienced individuals at a single time point. Participants, aged 10 years and above, were purposively enrolled from six health facilities. Laboratory analyses included viral load, CD4 and CD8 counts, co-infection screening (hepatitis B/C, syphilis), liver and kidney function tests, haemoglobin estimation, and HIV-1/2 typing. Chi-square and logistic regression analyses were used to assess associations between participant demographics and clinical data with uncontrolled viremia and immune recovery. Results A total of 426 participants were recruited, comprising 159 ART-naïve and 267 ART-experienced individuals, with a mean age of 41.5 years. Median ART duration for ART-experienced was greater than 5 years. Infections included HIV-1 (78.6%), HIV-2 (2.1%), and dual HIV-1&2 (19.2%). Common comorbidities were anaemia (54.9%), hepatitis B (9.5%), and hypertension (8.2%). Most participant (97.9%) were on dolutegravir-anchored regimen. Among ART-naïve individuals, median viral load decreased from log10 5.16 at baseline to log10 4.64 copies/mL after six months (p = 0.0156). Median viral load for the ART-experienced arm was log10 3.23 copies/mL. Median CD4 count increased from 290 cells/mm³ in ART-naïve participants to 504 cells/mm³ at six-months post-ART (p = 0.0003) and 581 cells/mm³ in ART-experienced participants (p < 0.0001). ART-naïve participants were 19 times more likely to have unsuppressed viral loads at baseline compared to ART-experienced participants. ARTnaïve- participants had significantly decreased odds of immune recovery (aOR = 0.35, 95% CI: 0.140–0.85, p = 0.021), as did those with low CD4/CD8 ratio (aOR = 0.06, 95% CI: 0.02–0.20; p < 0.001). Kidney function and haemoglobin levels were significantly improved six-month post-ART among the ART-naïve group. Conclusion This study highlights the significant reduction in viral load and improved immune recovery following ART initiation despite uncontrolled viremia in a subset of participants. This cohort presents an opportunity to study Ghana’s local HIV epidemic, including HIV-1 and HIV-2, and impact of ART on disease progression.https://doi.org/10.1186/s12985-025-02873-wWHICH studyHIV cohortHIV cure researchWest AfricaGhanaHIV-1 |
| spellingShingle | Mark Appeaning Edwin Magomere Alberta Mawulawoe Abotsi Nana Ama Yeboaa Amoako Kirk Elorm Kouffie Becky Ewurama Tetteh Bridget Nana Darkoa Quist Christèle Nguepou Tchopba Gloria Akosua Ansa Evelyn Yayra Bonney Peter Kojo Quashie Slow virologic control but strong immune and metabolic recovery with dolutegravir-anchored therapy in an HIV cohort in Ghana Virology Journal WHICH study HIV cohort HIV cure research West Africa Ghana HIV-1 |
| title | Slow virologic control but strong immune and metabolic recovery with dolutegravir-anchored therapy in an HIV cohort in Ghana |
| title_full | Slow virologic control but strong immune and metabolic recovery with dolutegravir-anchored therapy in an HIV cohort in Ghana |
| title_fullStr | Slow virologic control but strong immune and metabolic recovery with dolutegravir-anchored therapy in an HIV cohort in Ghana |
| title_full_unstemmed | Slow virologic control but strong immune and metabolic recovery with dolutegravir-anchored therapy in an HIV cohort in Ghana |
| title_short | Slow virologic control but strong immune and metabolic recovery with dolutegravir-anchored therapy in an HIV cohort in Ghana |
| title_sort | slow virologic control but strong immune and metabolic recovery with dolutegravir anchored therapy in an hiv cohort in ghana |
| topic | WHICH study HIV cohort HIV cure research West Africa Ghana HIV-1 |
| url | https://doi.org/10.1186/s12985-025-02873-w |
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