Prevalence of unsuppressed viraemia in HIV positive female sex workers on the daily single dose TDF/3TC/EFV tablet for 6 months : PSI-Zimbabwe sex worker cohort

[摘要] ENGLISH ABSTRACT: Background: Data on viral suppression and adherence patterns of anti-retroviraltherapy (ART) naïve HIV positive female sex workers (FSWs) initiated on theTenofovir/lamivudine/Efavirenz (TDF/3TC/EFV) fixed dose combination are scarce inZimbabwe. The objectives of this study were to describe the prevalence of andfactors associated with unsuppressed viraemia as well as the mean adherence ofFSWs on the Efavirenz based fixed dose tablet after 6 months of treatment.Methods: A retrospective record review was done on 77 FSWs who had beeninitiated on TDF/3TC/EFV and had a 6 months post initiation viral load test result at 2FSW clinics in Gwanda and Bulawayo, Zimbabwe. Recruitment into the clinics wasdone between July 2013 and September 2015. Data on monthly adherence per pillcount, 6 months viral load test result and possible predictors of unsuppressedviraemia were collected.Results: Prevalence of unsuppressed viraemia after 6 months on TDF/3TC/EFVFDC tablet was 7.78% (95%CI, 1.67-13.92 %) while viral suppression occurred in92.22% (95%CI 83.8-97.1%). Based on the 35 patients with complete adherencedata, the mean adherence was 99.69% (95%CI, 99.48%-99.91%). All 35 hadadherence >95% classified as good. Only comorbidity (Adjusted OR 23.31, 95%CI1.74-310.65, p = 0.017) and baseline CD4 count (Adjusted OR 0.9886; 95%CI0.9774-0.9998, p= 0.047) showed independent associations with unsuppressedviraemia.Conclusion: In the first 6 months on TDF/3TC/EFV, ART there is a low prevalenceof unsuppressed viraemia, high viral suppression rates and high adherence rates innaïve HIV positive FSWs in our setting.

[发布机构] Stellenbosch University