Epidemiology of Second-Line Antiretroviral Therapy Use in a Decentralized HIV Care Center in Senegal: A Retrospective Cross-Sectional Study (2019 – 2023)
Malick Ngom
*
Department of Public Health, Faculty of Health Sciences, University Thies, Senegal.
Elhadj Daouda Diop
Laboratory of Physiology and Functional Explorations, Faculty of Health Sciences, University Thies, Senegal.
Serigne Souaibou Ba
Public Mental Health Facility of Marne, France.
Dominique Diouf
Yacinthe Thiandoum Health Center, Dakar, University of Dakar, Senegal.
Bachir Mansour Diallo
Abdou Aziz Hospital of Tivaouane, Iba Der Thiam University of Thiès, Senegal.
Kamadore Touré
Department of Public Health, Faculty of Health Sciences, University Thies, Senegal.
*Author to whom correspondence should be addressed.
Abstract
Background: Human immunodeficiency virus (HIV) drug resistance necessitates second-line antiretroviral therapy (ART) in resource-limited settings. This study assessed the epidemiology of second-line ART use in a decentralized Senegalese HIV care center.
Patients and Methods: A retrospective cross-sectional study (2019-2023) included 400 records of PLHIV from Cardinal Hyacinthe Thiandoum Health Center. Data on sociodemographics, clinical parameters, and ART history were analyzed using SPSS.
Results: Among 400 PLHIV, 20 (5.0%, 95% CI: 4-6%) required second-line ART. Most of them were women (80%), mean age of 58.5±15.5 years. The main switch reasons were treatment failure (55%) and intolerance (45%). Mean viral load pre-switch was 68,387±15,879 copies/mL; mean CD4 count was 293±60 cells/μL. All patients received AZT+3TC+LPV/r.
Conclusion: In this cohort of 400 patients followed at the Cardinal Hyacinthe Thiandoum Health Center, we observed that targeted therapeutic education was associated with fewer switches to second-line ART, potentially conserving resources for more complex cases. Decentralized HIV care with reinforced therapeutic education may reduce second-line ART needs, preserving resources for complex cases.
Keywords: HIV, second-line ART, drug resistance, Senegal, decentralized care