Evaluating Second-line ART Efficacy in Pediatric HIV1 Infections: A Study at Albert Royer Children's Hospital
Dieye Baïdy *
Centre Hospitalier National d’Enfants Albert Royer, Dakar, Senegal and Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal.
Diop Amadou
Centre Hospitalier National d’Enfants Albert Royer, Dakar, Senegal and Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal.
Niang Aïssatou Ahmet
Centre Hospitalier National Universitaire de Fann, Dakar, Senegal and Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal.
Sonko Mouhamadou Abdoulaye
Centre Hospitalier National d’Enfants Albert Royer, Dakar, Senegal.
Sarr Habibou
Centre Hospitalier National Universitaire de Fann, Dakar, Senegal and Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal.
Diallo Fatoumata
Centre Hospitalier National Universitaire de Fann, Dakar, Senegal and Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal.
LO Gora
Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal and Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal.
KA Roughyatou
Centre Hospitalier National Universitaire de Fann, Dakar, Senegal and Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal.
Diop-Ndiaye Halimatou
Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal and Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal.
Toure-Kane Coumba
Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal and Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal.
Cisse Moussa Fafa
Centre Hospitalier National d’Enfants Albert Royer, Dakar, Senegal and Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal.
Sow Ahmad Iyane
Centre Hospitalier National Universitaire de Fann, Dakar, Senegal and Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal.
Boye Cheikh Saad Bouh
Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal and Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal.
Dia Mouhamadou Lamine
Centre Hospitalier National Universitaire de Fann, Dakar, Senegal and Faculté de Médecine, de Pharmacie et d’Odontologie de Dakar, Senegal.
*Author to whom correspondence should be addressed.
Abstract
Introduction: In developing countries, around 15% of children infected with the Human Immunodeficiency Virus (HIV) have access to early diagnosis, and 28% are eligible for antiretroviral treatment (ART). The evaluation studies carried out in Senegal have been limited to children on first-line ART. The main objective of our study was to evaluate the efficacy of second-line ART.
Methodology: Data were collected at 3 different sites. This was a retrospective, longitudinal and analytical study, conducted from March 4 to August 28, 2015. The study population consisted of 65 HIV1-infected children. BD FACSCountTM Flow Cytometer for TCD4 lymphocyte counting. For genotyping, 2 sets of PCRs were required. Data were entered and analysed using Word/Excel 2013 and Epi-info7 software.
Results: We had 43 boys and 22 girls, giving a sex ratio of 1.95. The extreme ages were 5 and 15 years, and the mean age was 11.43 years. The majority belonged to stage 4 and 2 of the WHO classification. The clinical evolution was favourable in 86.15%, unfavourable in 3.07% and unspecified in 10.76%. We found 9 genotypes and recombinant forms; 80% of the strains were sequenced.
Discussion: The general aim of ART is the same as in adults. Clinical stages were not specified in 15.38% of cases. In total, 58.46% had an excellent immunovirological response. We conclude from this that a good IR doesn’t mean a good immunovirological evolution. Initiation of ART should be guided by genotyping.
Conclusion-Recommendations: ART reduced morbidity and mortality. Our study showed a virological failure rate of 21.53% and an IR rate of 86.15%.
Keywords: Human immunodeficiency virus, acquired immunodeficiency syndrome, viral ribonucleic acid, immuno-virological evaluation