Predictors of Viral Non-Suppression among Patients Living with HIV under Dolutegravir in Bunia, Democratic Republic of Congo: A Prospective Cohort Study

Roger T. Buju, Pierre Z. Akilimali, Erick N. Kamangu, Gauthier K. Mesia, Jean Marie N. Kayembe and Hippolyte N. Situakibanza
Additional contact information
Roger T. Buju: Department of Public Health, Faculté de Medicine, University of Bunia, Bunia P.O. Box 292, Congo
Pierre Z. Akilimali: Department of Biostatistics and Epidemiology, Kinshasa School of Public Health, University of Kinshasa, Kinshasa P.O. Box 11850, Congo
Erick N. Kamangu: Département des Sciences de Base, School of Medicine, University of Kinshasa, Kinshasa P.O. Box 11850, Congo
Gauthier K. Mesia: Département de Pharmacologie Clinique, School of Medicine, University of Kinshasa, Kinshasa P.O. Box 11850, Congo
Jean Marie N. Kayembe: Department Internal Medicine, School of Medicine, University of Kinshasa, Kinshasa P.O. Box 11850, Congo
Hippolyte N. Situakibanza: Department of Tropical Medicine and Infectious Disease, School of Medicine, University of Kinshasa, Kinshasa P.O. Box 11850, Congo

IJERPH, 2022, vol. 19, issue 3, 1-13

Abstract: The Democratic Republic of the Congo adopted the integrase inhibitor dolutegravir (DTG) as part of its preferred first-line HIV treatment regimen in 2019. This study aimed to identify predictors of viral non-suppression among HIV-infected patients under a DTG-based regimen in the context of ongoing armed conflict since 2017 in the city of Bunia in the DRC. We conducted a cohort study of 468 patients living with HIV under DTG in all health facilities in Bunia. We calculated the proportion of participants with an HIV RNA of below 50 copies per milliliter. About three in four patients (72.8%) in this cohort had a viral load (VL) of <50 copies/mL after 6–12 months. After controlling for the effect of other covariates, the likelihood of having non-suppression remained significantly lower among the 25–34 age group and self-reported naïve patients with a baseline VL of ≥50 copies/mL. The likelihood of having non-suppression remained significantly higher among those who were at advanced stages of the disease, those with abnormal serum creatinine, those with high baseline HIV viremia over 1000 copies/mL, and the Sudanese ethnic group compared to the reference groups. This study suggests that we should better evaluate adherence, especially among adolescents and economically vulnerable populations, such as the Sudanese ethnic group in the city of Bunia. This suggests that an awareness of the potential effects of DTG and tenofovir is important for providers who take care of HIV-positive patients using antiretroviral therapy (ART), especially those with abnormal serum creatinine levels before starting treatment.

Keywords: dolutegravir; virologic failure; conflict setting; Bunia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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