Trends of HIV Viral Load in Patients under Combined Antiretroviral Treatment in Bangui, Central African Republic

Background: The success of antiretroviral therapy requires better virological monitoring. We described the virological profile of patients on combined antiretroviral therapy (cART) for HIV/AIDS in Bangui, Central African Republic (CAR). Methods: In this prospective cohort study of patients who had been on combined antiretroviral therapy treatment (cART) for at least 12 months in Bangui, only one HIV plasma viral load per patient was realized at the Institut Pasteur of Bangui, between April 4th and November 28th, 2017. Sociodemographic and biological data were collected. Blood samples were taken for viral load. The biocentric generic human immunodeficiency virus (HIV) load test was used to quantify a ribonucleic acid (RNA) HIV-1. Data were analyzed with Stata software version 14. Chi-squared test was used to analyse viral load according to sex and age. The level of significance was set at P ≤ 0.05. Results: A total of 3569 patients were recruited, with a mean age of 40 years (median, 42 years; range, 1 - 84), patients aged 40 - 49 predominating (34.2%). The sex ratio was 0.4. No virus was detectable in plasma from 49.2% of patients, while 42.4% had virological failure (viral load, ≥1000 copies/mL) according to WHO criteria. The risk for virological failure decreased with age (P = 0.001) and was higher among females than males (P = 0.001). Conclusions: The rate of virological failure among patients on cART is very high in the CAR, despite the availability of and access to monitoring of HIV plasma viral load in Bangui. Therefore, adherence to treatment should be evaluated and reinforced in Bangui, CAR.