TITLE:
Clinical and Paraclinical Profile of People Living with Human Immunodeficiency Virus on Second Line Treatment in Kinshasa, Democratic Republic of Congo
AUTHORS:
Erick Ntambwe Kamangu, Bibi Bungu Bwiri, Georges Lelo Mvumbi
KEYWORDS:
Antiretroviral Treatment, Second Line, HIV, Kinshasa
JOURNAL NAME:
Open Access Library Journal,
Vol.6 No.7,
July
29,
2019
ABSTRACT: Context: For the year 2018, the Provincial Division of the National Program for the Fight against HIV/AIDS and Sexually Transmitted Diseases published for the city of Kinshasa a total of 58,327 People Living with HIV (PLHIV) on Antiretroviral Treatment (ART) of which 5,789 (9.9%) were on second-line ART. Objective: The objective of this study was to determine the clinical and paraclinical profile of people living with HIV on second-line treatment followed in Kinshasa. Methods: The present study was an exploratory cohort study to evaluate the profile of PLHIV on second-line of treatment in Kinshasa. All PLHIV confirmed on first-line treatment failure and second-line ART were selected for this study. The clinical and paraclinical parameters were recorded from the individual files of the patients selected on inclusion (D0) and after 6 months of treatment (M6). Viral Load (VL) determination was done by PCR on Abbott m2000rt and CD4 cell count was determined using BD Facs Count. The clinical and paraclinical parameters of M6 were compared with those taken on D0. Results: 50 patients were selected for this study based on the inclusion criteria. 27 patients (54%) were women. The age of the patients was between 18 and 82 years with an average of 50.5 ± 11.75 years. The dominant age group was of 46 to 55 years with 18 patients (36%). At inclusion, the mean duration of treatment under the 1st line was 35 ± 8 months of ART. Thirty-eight patients (76%) were on clinical stage 3 for HIV infection according to the World Health Organization (WHO) classification. The average patient weight on D0 was 54.36 ± 13.70 kg; the median value of CD4 was 217 cells/μl. At M6, 32 patients (64%) were in clinical stage 3; the average patient weight was 60.34 ± 13.07 kg. The median CD4 value on M6 was 371 cells/μl. The median value of the Viral Loads (VL) of the patients was 0 RNA copies/ml. After 6 months of ART, 36 patients (72%) experienced significant weight gain; 7 patients (14%) showed an improvement in their clinical status. 41 patients (82%) had an increase in baseline CD4 count and 31 patients (62%) had a VL less than 200 RNA copies/ml. Conclusion: Patients on second-line ART start treatment with a significantly higher average age. Biological parameters are systematically higher in general. After 6 months of ART, the second-line ART failure rate was estimated at 38% with a population with a visible weight gain.