Immunovirological discordance among female sex workers who start antiretroviral therapy in Burkina Faso

Wilfried Wenceslas Bazié (1) , Diane Yirgnur Somé (2) , Isidore Tiandiogo Traoré (3, 4) , Issouf Konaté (5, 6) , Souleymane Tassembedo (7) , Ajani Ousmane Taofiki (8) , Dramane Kania (9) , Abdoulaye Ouédraogo (10) , Bea Vuylsteke (11) , Caroline Gilbert (12, 13) , Nicolas Meda (14, 15) , Abdoul Salam Ouédraogo (16) , Nicolas Nagot (17, 18, 19)

1 Centre Muraz, Institut National de Santé Publique
2 Centre Muraz, Institut National de Santé Publique
3 Centre Muraz, Institut National de Santé Publique
4 Institut Supérieur des Sciences de la Santé, Université Nazi Boni,
5 Centre Muraz, Institut National de Santé Publique,
6 Institut Supérieur des Sciences de la Santé, Université Nazi Boni
7 Centre Muraz, Institut National de Santé Publique,
8 Centre Muraz, Institut National de Santé Publique,
9 Centre Muraz, Institut National de Santé Publique
10 Centre Muraz, Institut National de Santé Publique
11 Department of Public Health, Institute of Tropical Medicine,
12 Axe de Recherche Maladies Infectieuses et Immunitaires,
13 UNIVERSITE LAVAL
14 Centre Muraz, Institut National de Santé Publique
15 Département de Santé Publique, Unité de Formation et de Recherche en Sciences de la Santé
16 Institut Supérieur des Sciences de la Santé [Bobo-Dioulasso, Burkina Faso]
17 INSERM - Institut National de la Santé et de la Recherche Médicale
18 UNIVERSITE DES ANTILLES
19 EFS

Abstract Background In people living with HIV/AIDS (PLWHA), initiation of antiretroviral therapy (ART) leads to sustained effective suppression of viral replication and increasing CD4 + T cell count. However, a fraction of ART-treated patients still fail to reach adequate CD4 + T cell number despite a suppressed viral load (VL), and this phenomenon is defined as immunovirological discordance (IVD). In Africa, several studies have reported immunovirological outcomes of antiretroviral therapy, but little is known about IVD occurrence in Female sex workers (FSW). This study aimed to assess the prevalence of IVD and associated factors among a cohort of HIV infected FSW in Burkina Faso. Methods We conducted a cohort study from December 2003 to October 2016. Immunovirological discordance was defined as CD4 + T cell gain < 100 cells/µL despite a suppressed VL (VL < 1000 copies/mL) 12 months after ART initiation. The CD4 + T cells were counted using BD FACSCount™ System and point of care Pima™ CD4 + Analyzer. HIV-1 RNA was quantified by real-time polymerase-chain-reaction assay with the use of the ABI 7000 system. We conducted a logistic regression to identify factors associated with discordant responses. Results Among the 123 HIV-1 infected FSW having at least 12 months follow-up on ART, 105 (85.4%) achieved HIV-1 RNA suppression. Among the latter 25 gained less than 100 CD4 + T cells within 12 months follow-up. The IVD rate was 23.8% (95%CI 16.04%–33.11%). After adjustment for age, WHO clinical stage and ART regimen including nucleoside/nucleotide reverse transcriptase inhibitors, only baseline CD4 + T cell count between 200 to 350 cells/µL (adjusted OR: 4.15; 95%CI 1.13–15.22) and 350 to 500 cells/µL (adjusted OR: 17.50; 95%CI 2.68–114.31) remain significantly associated with IVD occurrence. Conclusions Immunovirological discordance response was common in FSW with proportions close to those observed in the general population. A diagnosis and personalized follow-up of patients who do not achieve full immune reconstitution would make it possible to avoid complications in terms of morbidity and mortality.

Domaines: Sciences du Vivant [q-bio]

Wilfried Wenceslas Bazié, Diane Yirgnur Somé, Isidore Tiandiogo Traoré, Issouf Konaté, Souleymane Tassembedo, et al.. Immunovirological discordance among female sex workers who start antiretroviral therapy in Burkina Faso. BMC Infectious Diseases, 2022, 22 (1), pp.117. ⟨10.1186/s12879-022-07109-8⟩. ⟨hal-03678123⟩