Prevalence of HIV-associated Co-infections and Clinical Characteristics among HIV/AIDS Outpatients in the Context of Dolutegravir Roll-out Program in Vietnam
The prevalence of significant HIV-associated co-infections and clinical data of HIV/AIDS outpatients in the context of dolutegravir (DTG) transition are sparsely reported in Vietnam. Treatments of HIV co-infection, including antifungals, anti-tuberculous drugs, and direct-acting antiviral agents for viral hepatitis C, potentially challenge the efficacy of DTG-based therapies in terms of drug-to-drug interactions. We conducted a single-center, cross-sectional study between June and October 2020 in Ho Chi Minh City, Vietnam. HIV-infected outpatients were enrolled in the study when they attended the clinic to receive medical consultations and antiretroviral therapy (ART). Descriptive analyses were performed to describe the data. A total of 406 HIV-infected participants were enrolled in the study. The prevalence of HIV co-infected with chronic viral hepatitis B and C were 9.9% and 10.6%, respectively. Approximately 22.2% of HIV-infected patients had a history of tuberculosis treatment, and roughly 9% of participants experienced invasive fungal infections, mainly cryptococcosis, taralomycosis, and Pneumocystic jirovecii pneumonia. History of sexually transmitted diseases accounted for 40.4%. At the time of DTG transition, roughly 93% of patients were clinically stable, with a median CD4 count of 603 cells/µl. Two-thirds of HIV-infected patients achieved viral suppression (HIV viral load threshold < 20 copies/ml). A total of thirteen (3.2%) patients were ongoingly undertaking protease-inhibitors-based second-line ART regimens. The ART adherence was assessed at 92.1%. The prevalence of HIV-associated co-infections is still high in the context of DTG transition in Vietnam. More effort is needed in order to achieve the UNAIDS 90-90-90 targets.
Keywords: Dolutegravir, Invasive fungal infections, Tuberculosis, Viral hepatitis, Vietnam.
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