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Estimated rates of treatment failure in first-line antiretroviral treatment in Kinshasa: Case of the ACS AMO-Congo

Introduction: In the Democratic Republic of Congo (DRC), the first line of treatment for HIV adopted since 2008 for the PLHIV is a combination of single-dose Azydothimidine (AZT), Lamivudine (3TC) and Nevirapine (NVP). In 2009, 34 947 PLHIV were on the first line HAART in the DRC, of which 28,918 or 82.75% were adults.

Objective: Estimate the rate of treatment failure in first-line antiretroviral therapy in treatment centers in Kinshasa.

Method: This study is a cross-sectional study in three outpatient treatment centers of the NGO ACS AMO-Congo in the city of Kinshasa in the Democratic Republic of Congo in January 2009. Any patient on antiretroviral therapy in first intension followed regularly in one of three centers of study for more than six months in January 2009 was considered. Blood sampling was done in a tube with EDTA anticoagulant, from a venous puncture. The numbering of CD4 has been made in the laboratory of ACS / AMO-Congo Kasa Vubu on FACSCountTM and viral load at the National Reference Laboratory AIDS / STI (LNRS) by NucliSens Easy Q - HIV1, Version 1, 2. Data were entered using Excel and SPSS software. The Student test was used for quantitative variables and Chi-square (X2) for categorical variables. The significance (p) was chosen for the probability of p <0.05. Results are expressed as mean ± standard deviation. The tables have been reformatted in Excel. Respect for the individual and the confidentiality of records were found.

Result: A total of 102 patients were included in this work with a female predominance (66.7%) and a mean age of 41.4 ± 9.4 years. The mean CD4 count of third control (395.5 ± 145.2 cells / l) were significantly higher than those of CD4 at baseline (252.1 ± 128.7 cells / l). Controls were performed CD4 at 1 month (control 1), 3 months (control 2) and ± 6 months (control 3). The viral load (VL) average of 20,258.3 ± 10,209.0 RNA copies / ml. Eighteen patients (17.6%) had a CD4 count lower than the third control values before treatment, 16 patients (15.7%) had a viral load above 1000 RNA copies / ml and 7 patients (6.9%) evolved at the AIDS stage.

Conclusion: The estimated rate of treatment failure of patients on ARV first line in Kinshasa conducted in 3 treatment centers for AMO-Congo gave a rate of 17.6%.


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