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Article

Laboratory Based Surveillance of HIV-1 Acquired Drug Resistance in Cameroon: Implications for Use of Tenofovir-Lamivudine-Dolutegravir (TLD) as Second- or Third-Line Regimens

by
Joseph Fokam
1,2,3,4,*,
Collins Ambe Chenwi
1,2,5,*,
Desire Takou
1,
Maria Mercedes Santoro
5,
Valere Tala
1,2,
George Teto
1,
Grace Beloumou
1,
Ezechiel Ngoufack Jagni Semengue
1,5,
Beatrice Dambaya
1,
Sandrine Djupsa
1,
Etienne Kembou
6,
Nounouce Pamen Bouba
7,
Rogers Ajeh
8,
Giulia Cappelli
9,
Dora Mbanya
2,10,11,
Vittorio Colizzi
1,5,
Francesca Ceccherini-Silberstein
5,
Carlo-Federico Perno
1,12,† and
Alexis Ndjolo
1,2,†
1
Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Messa, Yaoundé P.O. Box 3077, Cameroon
2
Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon
3
National HIV Drug Resistance Working Group (HIVDRWG), Ministry of Public Health, Yaoundé P.O. Box 3038, Cameroon
4
Faculty of Health Sciences, University of Buea, Buea P.O. Box 063, Cameroon
5
Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy
6
World Health Organisation, Country Office, Yaoundé P.O. Box 155, Cameroon
7
Department of Disease, Epidemic and Pandemic Control, Ministry of Public Health, Yaoundé P.O. Box 3038, Cameroon
8
Central Technical Group, National AIDS Control Committee, Yaoundé P.O. Box 2005, Cameroon
9
Italian National Research Council, P. le Aldo Moro, 7, 00185 Rome, Italy
10
National Blood Transfusion Service, Ministry of Public Health, Yaoundé P.O. Box 3038, Cameroon
11
Haematology and Transfusion Service, Centre Hospitalier et Universitaire (CHU), Yaounde-13, Yaoundé P.O Box 30335, Cameroon
12
Bambino Gesu’ Children’s Research Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy
 
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*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Viruses 2023, 15(8), 1683; https://doi.org/10.3390/v15081683
Submission received: 28 March 2023 / Revised: 1 June 2023 / Accepted: 13 June 2023 / Published: 2 August 2023
(This article belongs to the Special Issue Advances in Research on HIV Drug Resistance and Other Determinants of Treatment Success)
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Abstract

Increased HIV drug resistance (HIVDR) with antiretroviral therapy (ART) rollout may jeopardize therapeutic options, especially in this era of transition to fixed-dose tenofovir-lamivudine-dolutegravir (TLD). We studied acquired HIVDR (ADR) patterns and describe potentially active drugs after first- and second-line failure in resource-limited settings (RLS) like Cameroon. A laboratory-based study with 759 patients (≥15 years) experiencing virological failure was carried out at the Chantal Biya International Reference Centre (CIRCB), Yaoundé, Cameroon. Socio-demographic, therapeutic and immunovirological data from patient records were analysed according to HIV-1 genotypic profiles. Median (IQR) ART-duration was 63 (50–308) months. Median CD4 and viremia were 153 (IQR:50–308) cells/mm3 and 138,666 (IQR:28,979–533,066) copies/mL, respectively. Overall ADR was high (93.4% first-line; 92.9%-second-line). TDF, potentially active in 35.7% of participants after first-line and 45.1% after second-line, suggested sub-optimal TLD-efficacy in second-line (64.3%) and third-line (54.9%). All PI/r preserved high efficacy after first-line failure while only DRV/r preserved high-level efficacy (87.9%) after second-line failure. In this resource-limited setting (RLS), ADR is high in ART-failing patients. PI/r strategies remain potent backbones for second-line ART, while only DRV/r remains very potent despite second-line failure. Though TLD use would be preferable, blind use for second- and third-line regimens may be sub-optimal (functional monotherapy with dolutegravir) with high risk of further failure, thus suggesting strategies for selective ART switch to TLD in failing patients in RLS.
Keywords: laboratory-based surveillance; acquired drug resistance; tenofovir-lamivudine-dolutegravir; TLD; first-line failure; second-line failure laboratory-based surveillance; acquired drug resistance; tenofovir-lamivudine-dolutegravir; TLD; first-line failure; second-line failure

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MDPI and ACS Style

Fokam, J.; Chenwi, C.A.; Takou, D.; Santoro, M.M.; Tala, V.; Teto, G.; Beloumou, G.; Semengue, E.N.J.; Dambaya, B.; Djupsa, S.; et al. Laboratory Based Surveillance of HIV-1 Acquired Drug Resistance in Cameroon: Implications for Use of Tenofovir-Lamivudine-Dolutegravir (TLD) as Second- or Third-Line Regimens. Viruses 2023, 15, 1683. https://doi.org/10.3390/v15081683

AMA Style

Fokam J, Chenwi CA, Takou D, Santoro MM, Tala V, Teto G, Beloumou G, Semengue ENJ, Dambaya B, Djupsa S, et al. Laboratory Based Surveillance of HIV-1 Acquired Drug Resistance in Cameroon: Implications for Use of Tenofovir-Lamivudine-Dolutegravir (TLD) as Second- or Third-Line Regimens. Viruses. 2023; 15(8):1683. https://doi.org/10.3390/v15081683

Chicago/Turabian Style

Fokam, Joseph, Collins Ambe Chenwi, Desire Takou, Maria Mercedes Santoro, Valere Tala, George Teto, Grace Beloumou, Ezechiel Ngoufack Jagni Semengue, Beatrice Dambaya, Sandrine Djupsa, and et al. 2023. "Laboratory Based Surveillance of HIV-1 Acquired Drug Resistance in Cameroon: Implications for Use of Tenofovir-Lamivudine-Dolutegravir (TLD) as Second- or Third-Line Regimens" Viruses 15, no. 8: 1683. https://doi.org/10.3390/v15081683

APA Style

Fokam, J., Chenwi, C. A., Takou, D., Santoro, M. M., Tala, V., Teto, G., Beloumou, G., Semengue, E. N. J., Dambaya, B., Djupsa, S., Kembou, E., Bouba, N. P., Ajeh, R., Cappelli, G., Mbanya, D., Colizzi, V., Ceccherini-Silberstein, F., Perno, C.-F., & Ndjolo, A. (2023). Laboratory Based Surveillance of HIV-1 Acquired Drug Resistance in Cameroon: Implications for Use of Tenofovir-Lamivudine-Dolutegravir (TLD) as Second- or Third-Line Regimens. Viruses, 15(8), 1683. https://doi.org/10.3390/v15081683

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