Pharmaco‐virological algorithm to target risk of drug resistance among a population of HIV‐infected key populations in Togo

Author:

Ferré Valentine M.12ORCID,Bitty‐Anderson Alexandra M.34,Peytavin Gilles5,Lê Minh P.56,Dagnra Claver A.78,Coppée Romain1,Gbeasor‐Komlanvi Fifonsi A.39,Descamps Diane12,Charpentier Charlotte12,Ekouevi Didier K.349

Affiliation:

1. Université Paris Cité Inserm UMR_1137, IAME Paris France

2. Service de Virologie, AP‐HP Hôpital Bichat–Claude Bernard Paris France

3. Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP) Lomé Togo

4. National Institute for Health and Medical Research (INSERM) UMR 1219 University of Bordeaux Bordeaux France

5. Service de Pharmacologie, AP‐HP Hôpital Bichat–Claude Bernard Paris France

6. Université Paris Cité and Université Sorbonne Paris Nord, INSERM Paris France

7. Université de Lomé Centre de Biologie Moléculaire et d'Immunologie Lomé Togo

8. Programme national de lutte contre le sida et les infections sexuellement transmissibles Lomé Togo

9. Département de Santé Publique, Faculté des Sciences de la Santé Université de Lomé Lomé Togo

Abstract

AbstractNo data about antiretroviral (ARV) treatment coverage and virological response are available among key populations (female sex workers [FSW] and Men having Sex with Men [MSM]) in Togo. This study aimed to both describe Human Immunodeficiency Virus (HIV) immunovirological status and evaluate the pertinence of an original algorithm combining pharmacology (PK) and viral load (VL) to identify subjects at risk of ARV drug resistance. A cross‐sectional multicentric study was conducted in 2017 in Togo. Our PK‐virological algorithm (PK‐VA) defines subjects at risk of resistance when exhibiting both detectable plasma drug concentrations and VL > 200 c/mL. Among the 123 FSW and 136 MSM included, 50% and 66% were receiving ARV, with 69% and 80% of them successfully‐treated, respectively. Genotypes showed drug‐resistance mutation in 58% and 63% of nonvirologically controlled (VL > 200 c/mL) ARV‐treated FSW and MSM, respectively. PK‐VA would have enabled to save 75% and 72% of genotypic tests, for FSW and MSM, respectively. We reported first data about HIV care cascade among key populations in Togo, highlighting they are tested for HIV but linkage to care remains a concern. Furthermore, 70%−80% of ARV‐treated participants experienced virological success. In limited resources settings, where genotyping tests are beyond reach, PK‐VA might be an easiest solution to sort out patients needing ARV adaptation due to resistance.

Publisher

Wiley

Subject

Infectious Diseases,Virology

Reference17 articles.

1. Conseil National de Lutte contre le SIDA et les IST. Rapport d'activité sur la riposte au VIH/SIDA au Togo [Internet]. 2015.https://www.unaids.org/sites/default/files/country/documents/TGO_narrative_report_2015.pdf

2. HIV prevalence and risk behaviors among female sex workers in Togo in 2017: a cross-sectional national study

3. Prevalence of Human Papillomavirus, Human Immunodeficiency Virus, and Other Sexually Transmitted Infections Among Men Who Have Sex With Men in Togo: A National Cross-sectional Survey

4. Prevalence of HIV infection and hepatitis B and factors associated with them among men who had sex with men in Togo in 2017;Sadio AJ;Med Sante Trop,2019

5. Ending the epidemic of HIV/AIDS by 2030: Will there be an endgame to HIV, or an endemic HIV requiring an integrated health systems response in many countries?

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