title: Incidence of infectious morbidity events after second-line antiretroviral therapy initiation in HIV-infected adults in Yaoundé, Cameroon.
abstract: Since antiretroviral therapy (ART), HIV-infected individuals experience mainly non-AIDS-related conditions, among which infectious events are prominent. We aimed to estimate incidence and describe overall spectrum of infectious events, including all grade events, among HIV-1-infected adults failing first-line ART in Yaoundé, Cameroon.
  
  
  
  All patients from Cameroon enrolled in the second-line ART 2LADY trial (ANRS12169) were included in this secondary analysis. Medical files were reviewed with predefined criteria for diagnosis assessment. Incidence rates (IR) were estimated per 100 person-years (% PY).
  
  
  
  A total of 302 adult patients contributing 840 PY experienced 596 infectious events (IR 71% PY). Only 29 (5%) events were graded as severe. Most frequent infections were upper respiratory tract infections (15% PY), diarrhoea (9% PY) and malaria (9% PY). A total of 369 (62%) infections occurred during the first year (IR 130% PY) followed by a persistent lower incidence during the following 3 years. Higher IR were observed in patients with CD4+T-cell count <200 cells/mm3for all infectious events except for mycobacterial and parasitic infections. IR of viral, bacterial and parasitic infectious events were lower in case of co-trimoxazole use in patients with CD4+T-cell count <200 cells/mm3.
  
  
  
  Infectious events are common and mainly occur during the first year after treatment initiation. Second-line ART initiation had a positive impact on the entire spectrum of infectious morbidity.
authors.affiliation: Institut de Recherche pour le Développement (IRD) UMI233, INSERM U1175, University of Montpellier, Montpellier, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Galy
authors.affiliation: Institut de Recherche pour le Développement (IRD) UMI233, INSERM U1175, University of Montpellier, Montpellier, France.|ANRS Research Center, Hôpital Central de Yaoundé, Yaoundé, Cameroon.
authors.forename: Laura
authors.initials: L
authors.lastname: Ciaffi
authors.affiliation: Institut de Recherche pour le Développement (IRD) UMI233, INSERM U1175, University of Montpellier, Montpellier, France.|Department of Infectious Diseases, University Hospital, Montpellier, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Le Moing
authors.affiliation: Institut de Recherche pour le Développement (IRD) UMI233, INSERM U1175, University of Montpellier, Montpellier, France.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Eymard-Duvernay
authors.affiliation: ANRS Research Center, Hôpital Central de Yaoundé, Yaoundé, Cameroon.
authors.forename: Hermine
authors.initials: H
authors.lastname: Abessolo
authors.affiliation: ANRS Research Center, Hôpital Central de Yaoundé, Yaoundé, Cameroon.
authors.forename: Roselyne
authors.initials: R
authors.lastname: Toby
authors.affiliation: Region 1 Military Hospital, Yaoundé, Cameroon.
authors.forename: Liliane
authors.initials: L
authors.lastname: Ayangma
authors.affiliation: ANRS Research Center, Hôpital Central de Yaoundé, Yaoundé, Cameroon.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Le Gac
authors.affiliation: Region 1 Military Hospital, Yaoundé, Cameroon.
authors.forename: Mireille
authors.initials: M
authors.lastname: Mpoudi-Etame
authors.affiliation: ANRS Research Center, Hôpital Central de Yaoundé, Yaoundé, Cameroon.|Faculté de Médecine et des Sciences Biomédicales (FMSB), University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Sinata
authors.initials: S
authors.lastname: Koulla-Shiro
authors.affiliation: Institut de Recherche pour le Développement (IRD) UMI233, INSERM U1175, University of Montpellier, Montpellier, France.|Department of Infectious Diseases, University Hospital, Montpellier, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Delaporte
authors.affiliation: Institut de Recherche pour le Développement (IRD) UMI233, INSERM U1175, University of Montpellier, Montpellier, France.
authors.forename: Amandine
authors.initials: A
authors.lastname: Cournil
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000276:immunology; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002163:Cameroon / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011446:Prospective Studies; D017211:Treatment Failure
chemical_list: D019380:Anti-HIV Agents