Programmatic assessment of a third-line regimen implementation for adult HIVinfected in Cambodia
Author : Pheng, Phearavin
Under the direction of : Laurence Meyer et Cécile Goujard
Université Paris-Saclay
English text
Keywords : Epidemiology, Cambodia
Abstract
There is limited evidence to guide HIV thirdline strategies in resource-limited settings, including Cambodia. The 3DICAM study evaluated the effectiveness of a third-line regimen with dolutegravir, darunavir and optimized NRTI in 49 patients failing a second-line. At week 24, 59% of patients had viral load suppressed. Plasma concentrations of antiretrovirals were close to those in other populations. Risk factors for virological failure included low CD4 counts<200 and infection through MTCT. Regarding HCV infection, data are needed to meet WHO targets of eliminating HCV by 2030 in Cambodia. In a cross-sectional survey of HCV seroprevalence among 425 PLHIV and 510 pregnant women, HCV seroprevalence was 6.8% vs. 0.9%. In PLHIV, HCV infection was associated with having a family member positive for HCV and intravenous medication injection. To conclude, a third-line regimen combining DRV, DTG and optimized NRTI is effective to significantly decrease viral load. Our results highlight a need for systematic HCV testing and care among PLHIV and their family members.
