Epidemiological and Virological Aspects of People Living with HIV-1 on Antiretroviral Therapy in Thierno Birahim NDAO Regional Hospital of Kaffrine, Senegal

Abstract

Background: Human immunodeficiency virus infection remains a public health challenge, mostly in sub-Saharan Africa. This region accounts for 65% of those infected and contributes to 50% of new infections. WHO advocates for early antiretroviral therapy (ART) initiation for all newly diagnosed individuals. If monitoring viral load (VL) after ART initiation is increasingly common, baseline VL testing is under-utilized in resource-limited settings. This study intends to describe the epidemiological, virological, and therapeutic aspects of people living with HIV on antiretroviral therapy in Kaffrine Regional Hospital. Methods: We performed a retrospective analysis of data from an open cohort of PLWHIV followed at the Thierno Birahim NDAO Regional Hospital of Kaffrine who initiated antiretroviral therapy from 2020 to 2022. For diagnosis, a three-test HIV screening algorithm was used in accordance with the recommendations of the National AIDS Control Council (NACC). HIV RNA was quantified by using GeneXpert ® technology assay. R esults: There were 257 PLWHIV included, women were the most representative gender group with 68.5%. The median age was 45 years at the inclusion and 99.6% (n = 256) of patients were infected with HIV-1 and 0.4% (n = 1) with HIV-1 and HIV-2 dually. The majority of people living with HIV (66.5%; n = 171) were diagnosed following medical care for various HIV-related conditions. All patients were on antiretroviral treatment and the most commonly used treatment was the combination Tenofovir + Lamivudine + Dolutegravir (98.44%; n = 253). Majority of people living with HIV (57.2%; n = 147) had an undetectable viral load. Distribution of viral load according to age group showed a significant pattern (p < 0.001), with higher viral loads observed in the 41 - 50 years age group. Among people living with HIV on antiretroviral therapy, 49 patients (19.1%) experienced virological failure. Conclusion: These results suggest the need to make new therapeutic classes available for first-line treatment and to promote actions improving retention in care.