Version 2: Epidemiological and virological characteristics of people living with HIV on antiretroviral treatment for more than six months in virological failure in Brazzaville, Republic of Congo

Introduction: Virological failure is one of the major causes of treatment failure, and better management of HIV infection requires understanding and controlling the factors that contribute to this phenomenon. The main objective was to characterize the patients of the active file of the Brazzaville Outpatient Treatment Center in virological failure in order to identify predictive factors that lead to virological failure. 

Methods: This was a cross-sectional study conducted between June and December 2020. Patients enrolled were HIV-1 infected patients from the Brazzaville Outpatient Treatment Center receiving a potent combination therapy for at least 6 months but experiencing virological failure. Viral load was determined with the automated Abbott Real-time HIV-1 m2000rt System. Sociodemographic and clinical data were collected from a computerized patient record software called Santia. Statistical analysis was performed to identify independent predictors of virological failure. 

Results: A total of 109 patients with virological failure were recruited. The median age of the patients was 45 years (IQR: 37-52 years) and women were more represented (74%). More than half of the patients had WHO stage IV HIV and the median duration on ARV treatment was 96 months. The most followed treatment regimen was AZT+3TC+EFV (or NVP) with 48% while the median viral load was 12,985 copies/mL. 

Conclusion: In our study, we did not identify any sociodemographic or clinical variables predictive of virological failure. However, we felt that it would be desirable to carry out a study with temporal follow-up and the possibility of sequencing in order to identify the different circulating genotypes and resistance mutations.