Lidaw Déassoua Bawe*, Akouda Akessiwè Patassi, Awèréou Kotosso, Abdou-Razak Moukaïla, Bawoubadi Abaltou, Majesté Ihou Wateba
Objective: Evaluate the conditions and criteria for starting third line antiretroviral treatment for patients who have failed second line treatment.
Materials and methods: Retrospective cohort study from January 1, 2013 to December 31, 2018 for patients who were already on third line ART and then a cross-sectional study from January 1 to June 30, 2019 for patients to be put on third line antiretroviral treatment. It was conducted in at the Day Hospital of the Department of Infectious and Tropical Diseases of Sylvanus Olympio Teaching Hospital.
Results: Seventy-six patients have been put under third line antiretroviral treatment from June 30, 2019 among the 3383 patients in the active queue of patients regularly monitored. The average age of the patients was 43.53 years (12-69 years). Almost all patients were HIV-infected1 (n=75). The average duration of HIV infection diagnosis was 10.77 years (2-21 years). The average duration ART of first and second line was 8.8 years. The average rate of CD4 count at the time of failure was 110.3 cells/μl (0-664 cells/μl). The viral load was done in 79% with an average of 44,023,958.35 copies. Only 17 patients or 22.4% were able to complete genotyping. Weight loss/deterioration of general condition (n=49) was the sign presented by most patients.Darunavir and Raltegravir were associated with all combinations of third line antiretroviral therapy in most ca sLees.thality was 12% (n=9).
Conclusion: Diagnosis of treatment failure is mainly based on clinical signs or events, CD4 count and to a certain extent viral load measurement. The use of genotyping, which is not available in Togo, depends on the patient's financial possibilities or capacities.