Incidence of infectious morbidity events after second-line antiretroviral therapy initiation in HIV-infected adults in Yaoundé, Cameroon

Antivir Ther. 2016;21(6):547-552. doi: 10.3851/IMP3030. Epub 2016 Feb 16.

Abstract

Background: Since antiretroviral therapy (ART), HIV-infected individuals experience mainly non-AIDS-related conditions, among which infectious events are prominent. We aimed to estimate incidence and describe overall spectrum of infectious events, including all grade events, among HIV-1-infected adults failing first-line ART in Yaoundé, Cameroon.

Methods: All patients from Cameroon enrolled in the second-line ART 2LADY trial (ANRS12169) were included in this secondary analysis. Medical files were reviewed with predefined criteria for diagnosis assessment. Incidence rates (IR) were estimated per 100 person-years (% PY).

Results: A total of 302 adult patients contributing 840 PY experienced 596 infectious events (IR 71% PY). Only 29 (5%) events were graded as severe. Most frequent infections were upper respiratory tract infections (15% PY), diarrhoea (9% PY) and malaria (9% PY). A total of 369 (62%) infections occurred during the first year (IR 130% PY) followed by a persistent lower incidence during the following 3 years. Higher IR were observed in patients with CD4+ T-cell count <200 cells/mm3 for all infectious events except for mycobacterial and parasitic infections. IR of viral, bacterial and parasitic infectious events were lower in case of co-trimoxazole use in patients with CD4+ T-cell count <200 cells/mm3.

Conclusions: Infectious events are common and mainly occur during the first year after treatment initiation. Second-line ART initiation had a positive impact on the entire spectrum of infectious morbidity.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / epidemiology*
  • AIDS-Related Opportunistic Infections / immunology
  • Adult
  • Anti-HIV Agents / therapeutic use*
  • CD4 Lymphocyte Count
  • Cameroon / epidemiology
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV-1
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Morbidity
  • Prospective Studies
  • Treatment Failure

Substances

  • Anti-HIV Agents