Three-Year Outcomes After Genotyping-Guided Treatment Switch in HIV Patients with Virologic Failure in Cameroon: Implications for Epidemic Control in Low- and Middle-Income Countries.

Authors

Ezechiel Ngoufack Jagni Semengue, Chanelle Magnilack Kuete, Abdel Jelil Njouendou, Collins Ambe Chenwi, Dell-Dylan Kenfack, Vincent Kamaël Mekel, Joseph Matute Njako, Stella Diabe Munge, Ladifatou Supuen, Linda Berinyuy, Synthia Njuzy Eduke, Pamela Patricia Tueguem, Désiré Takou, Grâce Beloumou Angong, Sandrine Claire Djupsa Ndjeyep, Alex Durand Nka, Aude Christelle Ka'e, Naomi-Karell Etame, Evariste Molimbou, Tatiana Anim-Keng Tekoh, Derrick Tambe Ayuk Ngwese, Larissa Gaelle Moko Fotso, Anne-Cecile Z-K Bissek, Carlo-Federico Perno, Nicaise Ndembi, Joseph Fokam, Alexis Ndjolo

Published in

Journal of global antimicrobial resistance. Jul 24, 2026. Epub Jul 24, 2026.

Abstract

Monitoring of HIV-infected patients with long-term treatment remains challenging in low- and middle-income countries (LMICs) due to risks of multi-class HIV drug resistance (HIVDR). We sought to evaluate the treatment response after a genotypic resistance-guided treatment switch among patients with multi-class HIVDR in Cameroon.
A retrospective cohort study was conducted in the South-West region of Cameroon among patients failing first- and second-line antiretroviral treatment (ART) (i.e., non-nucleoside reverse transcriptase inhibitors (NNRTI)- and protease inhibitor (PI)-based) from 2018-2023. Following HIV-1 genotypic resistance testing (GRT), patients were switched to the most effective genotype-guided therapies and viral load (VL) was monitored thereafter. Data analysis was performed using Epi-Info v.7.2, with p<0.05 considered significant.
Overall, 81 patients were included in the study (median CD4 and VL were 232.5 [161.25-401.25] cells/µL and 54,480 [13,932.5-220,153] copies/mL, respectively). HIVDR at failure (i.e., VL>1000copies/mL) was 61.7%, and prevailing mutations were M184V (24.6%), K103N (17%) and M46I (32.1%) for NRTI, NNRTI and PI respectively. Monitoring data revealed 92.6% of adherence to the prescribed regimen. Viral suppression post-GRT was 80% at 3-months, 84.8% at 6-months, 81.4% at 12-months, 93.7% at 24-months and 86.9% at 36-months. Furthermore, DTG-based regimens yielded significantly higher responses than DTG-sparing regimens up to 24-months (p=0.013, p=0.0015, p=0.0005, p=0.02, respectively).
Our findings highlight sustained viral suppression over three years following GRT-guided switch among individuals with multi-class HIVDR, mainly driven by DTG-based regimens. This underscores the significance of personalizing ART-management for difficult-to-treat people to achieve HIV control by 2030 in LMICs.

PMID:
42497908
Bibliographic data and abstract were imported from PubMed on 25 Jul 2026.

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