Survival among antiretroviral-experienced HIV-2 patients experiencing virologic failure with drug resistance mutations in Cote d'Ivoire West Africa.
<h4>Introduction</h4>The long-term prognosis of HIV-2-infected patients receiving antiretroviral therapy (ART) is still challenging, due to the intrinsic resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) and the suboptimal response to some protease inhibitors (PI). Th...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2020-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0236642 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849225161891381248 |
|---|---|
| author | Boris K Tchounga Charlotte Charpentier Patrick A Coffie François Dabis Diane Descamps Serge P Eholie Didier K Ekouevi |
| author_facet | Boris K Tchounga Charlotte Charpentier Patrick A Coffie François Dabis Diane Descamps Serge P Eholie Didier K Ekouevi |
| author_sort | Boris K Tchounga |
| collection | DOAJ |
| description | <h4>Introduction</h4>The long-term prognosis of HIV-2-infected patients receiving antiretroviral therapy (ART) is still challenging, due to the intrinsic resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) and the suboptimal response to some protease inhibitors (PI). The objective was to describe the 5-years outcomes among HIV-2 patients harboring drug-resistant viruses.<h4>Methods</h4>A clinic-based cohort of HIV-2-patients experiencing virologic failure, with at least one drug resistance mutation was followed from January 2012 to August 2017 in Côte d'Ivoire. Follow-up data included death, lost to follow-up (LTFU), immuno-virological responses. The Kaplan-Meier curve was used to estimate survival rates.<h4>Results</h4>A total of 31 HIV-2 patients with virologic failure and with at least one drug resistance mutation were included. Two-third of them were men, 28(90.3%) were on PI-based ART-regimen at enrolment and the median age was 50 years (IQR = 46-54). The median baseline CD4 count and viral load were 456 cells/mm3 and 3.7 log10 c/mL respectively, and the participants have been followed-up in median 57 months (IQR = 24-60). During this period, 21 (67.7%) patients switched at least one antiretroviral drug, including two (6.5%) and three (9.7%) who switched to a PI-based and an integrase inhibitor-based regimen respectively. A total of 10(32.3%) patients died and 4(12.9%) were LTFU. The 36 and 60-months survival rates were 68.5% and 64.9%, respectively. Among the 17 patients remaining in care, six(35.3%) had an undetectable viral load (<50 c/mL) and for the 11 others, the viral load ranged from 2.8 to 5.6 log10 c/mL. Twelve patients were receiving lopinavir at the time of first genotype, five(42%) had a genotypic susceptibility score (GSS) ≤1 and 4(33%) a GSS >2.<h4>Conclusions</h4>The 36-months survival rate among ART-experienced HIV-2 patients with drug-resistant viruses is below 70%,lower than in HIV-1. There is urgent need to improve access to second-line ART for patients living with HIV-2 in West Africa. |
| format | Article |
| id | doaj-art-22957cbfd7de4cc0aa2add933c849ad0 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-22957cbfd7de4cc0aa2add933c849ad02025-08-25T05:31:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01158e023664210.1371/journal.pone.0236642Survival among antiretroviral-experienced HIV-2 patients experiencing virologic failure with drug resistance mutations in Cote d'Ivoire West Africa.Boris K TchoungaCharlotte CharpentierPatrick A CoffieFrançois DabisDiane DescampsSerge P EholieDidier K Ekouevi<h4>Introduction</h4>The long-term prognosis of HIV-2-infected patients receiving antiretroviral therapy (ART) is still challenging, due to the intrinsic resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) and the suboptimal response to some protease inhibitors (PI). The objective was to describe the 5-years outcomes among HIV-2 patients harboring drug-resistant viruses.<h4>Methods</h4>A clinic-based cohort of HIV-2-patients experiencing virologic failure, with at least one drug resistance mutation was followed from January 2012 to August 2017 in Côte d'Ivoire. Follow-up data included death, lost to follow-up (LTFU), immuno-virological responses. The Kaplan-Meier curve was used to estimate survival rates.<h4>Results</h4>A total of 31 HIV-2 patients with virologic failure and with at least one drug resistance mutation were included. Two-third of them were men, 28(90.3%) were on PI-based ART-regimen at enrolment and the median age was 50 years (IQR = 46-54). The median baseline CD4 count and viral load were 456 cells/mm3 and 3.7 log10 c/mL respectively, and the participants have been followed-up in median 57 months (IQR = 24-60). During this period, 21 (67.7%) patients switched at least one antiretroviral drug, including two (6.5%) and three (9.7%) who switched to a PI-based and an integrase inhibitor-based regimen respectively. A total of 10(32.3%) patients died and 4(12.9%) were LTFU. The 36 and 60-months survival rates were 68.5% and 64.9%, respectively. Among the 17 patients remaining in care, six(35.3%) had an undetectable viral load (<50 c/mL) and for the 11 others, the viral load ranged from 2.8 to 5.6 log10 c/mL. Twelve patients were receiving lopinavir at the time of first genotype, five(42%) had a genotypic susceptibility score (GSS) ≤1 and 4(33%) a GSS >2.<h4>Conclusions</h4>The 36-months survival rate among ART-experienced HIV-2 patients with drug-resistant viruses is below 70%,lower than in HIV-1. There is urgent need to improve access to second-line ART for patients living with HIV-2 in West Africa.https://doi.org/10.1371/journal.pone.0236642 |
| spellingShingle | Boris K Tchounga Charlotte Charpentier Patrick A Coffie François Dabis Diane Descamps Serge P Eholie Didier K Ekouevi Survival among antiretroviral-experienced HIV-2 patients experiencing virologic failure with drug resistance mutations in Cote d'Ivoire West Africa. PLoS ONE |
| title | Survival among antiretroviral-experienced HIV-2 patients experiencing virologic failure with drug resistance mutations in Cote d'Ivoire West Africa. |
| title_full | Survival among antiretroviral-experienced HIV-2 patients experiencing virologic failure with drug resistance mutations in Cote d'Ivoire West Africa. |
| title_fullStr | Survival among antiretroviral-experienced HIV-2 patients experiencing virologic failure with drug resistance mutations in Cote d'Ivoire West Africa. |
| title_full_unstemmed | Survival among antiretroviral-experienced HIV-2 patients experiencing virologic failure with drug resistance mutations in Cote d'Ivoire West Africa. |
| title_short | Survival among antiretroviral-experienced HIV-2 patients experiencing virologic failure with drug resistance mutations in Cote d'Ivoire West Africa. |
| title_sort | survival among antiretroviral experienced hiv 2 patients experiencing virologic failure with drug resistance mutations in cote d ivoire west africa |
| url | https://doi.org/10.1371/journal.pone.0236642 |
| work_keys_str_mv | AT borisktchounga survivalamongantiretroviralexperiencedhiv2patientsexperiencingvirologicfailurewithdrugresistancemutationsincotedivoirewestafrica AT charlottecharpentier survivalamongantiretroviralexperiencedhiv2patientsexperiencingvirologicfailurewithdrugresistancemutationsincotedivoirewestafrica AT patrickacoffie survivalamongantiretroviralexperiencedhiv2patientsexperiencingvirologicfailurewithdrugresistancemutationsincotedivoirewestafrica AT francoisdabis survivalamongantiretroviralexperiencedhiv2patientsexperiencingvirologicfailurewithdrugresistancemutationsincotedivoirewestafrica AT dianedescamps survivalamongantiretroviralexperiencedhiv2patientsexperiencingvirologicfailurewithdrugresistancemutationsincotedivoirewestafrica AT sergepeholie survivalamongantiretroviralexperiencedhiv2patientsexperiencingvirologicfailurewithdrugresistancemutationsincotedivoirewestafrica AT didierkekouevi survivalamongantiretroviralexperiencedhiv2patientsexperiencingvirologicfailurewithdrugresistancemutationsincotedivoirewestafrica |