EVALUATION DE L'EFFICACITÉ DES RÉGIMES ANTIRÉTROVIRAUX À BASE DE DOLUTEGRAVIR CHEZ LES ENFANTS INFECTÉS PAR LE VIH DANS UN HÔPITAL DE RÉFÉRENCE DE YAOUNDÉ, CAMEROUN

Abstract

Introduction: To slow down the progression of the disease, since 2018 the World Health Organization recommended antiretroviral treatment regimens combining an integrase inhibitor, Dolutegravir (DTG), and nucleoside reverse transcriptase inhibitors (NRTIs). The aim of this study was to evaluate the clinical and biological efcacy of DTG and Efavirenz (EFV) containing treatment regimens in children andadolescents.
Materials and methods: This was an 8-year retrospective comparative study (2015-2023) involving children and adolescents aged 3 to 19 years, divided into two groups, one receiving DTG-based antiretroviral therapy and the other EFV combined with NRTIs (abacavir/lamivudine or tenofovir/lamivudine). Viral suppression (<1,000 copies/ml) and viral undetectability (<50 copies/ml) were used as efcacy indicators.
Results: Of the 60 patients included, 35 (58.3%) were on EFV and 25 (41.7%) were on DTG. The mean viral load reduction rate was 96.2% and 97.9% after 6 and 12 months, respectively, for EFV and DTG. After 18 months of treatment, 100% of patients on DTG had achieved viral suppression compared to 91.7% on EFV. After 24 months, 72% of patients on DTG had an undetectable viral load, compared with 65.7% on EFV. The overall death rate was 5%, with a predominance in the EFV group.
Conclusion: Dolutegravir has demonstrated superior efcacy to efavirenz in terms of rapid and sustained viral load suppression in children and adolescents living with HIV.