HIV-1 plasma RNA mesearment and lymphocytes TCD4 count in the monitoring of antiretroviral treatment of HIV infected patients in Côte d’Ivoire; [Mesure de l’ARN VIH-1 et du taux de lymphocytes TCD4 dans le suivi du traitement antirétroviral de patients infectés par le VIH en Côte d’Ivoire]

Côte d'Ivoire national recommendations for biological monitoring of antiretroviral therapy (ART) include measurement of HIV RNA viral load (VL), but this assay remained inaccessible until 2013. Since 2014, VL was made routinely available with the financial support of UNITAID. The objective of the current study was to analyze the relevance of HIV1 RNA VL versus CD4 count (CD4) in this follow-up. Thus, people living with HIV (PLWH) receiving ART for at least 6 months had VL and CD4 measurements. A total number of 8410 patients were included with a median age of 41 years (1-91). Sex ratio was 0.46 and 91% of PLWH were on first-line treatment. Median CD4 count was 399 cells/μL (1-17185 /μL) and 80.3% of the patients had CD4 count higher than 200 cells/μL. The Median of VL was 4.61 log10/mL (2.5-7.60 log10/mL) and 73.8% of the cases had viral replication under control (<3 log10/mL). There were 50.1% cases of immuno-virological discordance of which 44.5% were virological success with immunological failure (I-/V+) avoiding an unnecessary change of therapeutic line and 5.6% of early screening of virological failure despite an immunological success (I+/V-). Finally, HIV-1 RNA allowed a better biological monitoring of antiretroviral therapy and its evolution must be monitored. © 2019 International Formulae Group. All rights reserved.