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Disparities in dolutegravir utilisation in children, adolescents and young adults (0-24 years) living with HIV. An analysis of the IeDEA Pediatric West African cohort
| dc.rights.license | open | en_US |
| dc.contributor.author | DESMONDE, Sophie | |
| dc.contributor.author | DAME, Joycelyn | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| hal.structure.identifier | Global Health in the Global South [GHiGS] | |
| dc.contributor.author | MALATESTE, Karen | |
| dc.contributor.author | DAVID, Agatha | |
| dc.contributor.author | AMORISSANI-FOLQUET, Madeleine | |
| dc.contributor.author | N'GBECHE, Sylvie | |
| dc.contributor.author | SYLLA, Mariam | |
| dc.contributor.author | TAKASSI, Elom | |
| dc.contributor.author | EBOUA, Francois Tanoh | |
| dc.contributor.author | KOUAKOU, Kouadio | |
| dc.contributor.author | BAGNAN TOSSA, Lehila | |
| dc.contributor.author | YONABA, Caroline | |
| dc.contributor.author | LEROY, Valeriane | |
| dc.contributor.author | COHORT., IeD. E. A. Pediat West African | |
| dc.date.accessioned | 2025-04-14T08:20:35Z | |
| dc.date.available | 2025-04-14T08:20:35Z | |
| dc.date.issued | 2025-01-14 | |
| dc.identifier.issn | 2059-7908 | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/206153 | |
| dc.description.abstractEn | Introduction We describe the 24-month incidence of Dolutegravir (DTG)-containing antiretroviral treatment (ART) initiation since its introduction in 2019 in West Africa. Methods We included all patients aged 0-24 years on ART from nine clinics in C & ocirc;te d'Ivoire (n=4), Ghana, Nigeria, Mali, Benin, and Burkina Faso. Baseline varied by clinic and was defined as date of first DTG prescription; patients were followed up until database closure/death/loss to follow-up (LTFU, no visit >= 7 months), whichever came first. We computed the cumulative incidence function for DTG initiation; associated factors were explored in a shared frailty model, accounting for clinic heterogeneity. Results Since 2019, 3350 patients were included; 47.2% were female; 78.9% had been on ART >= 12 months. Median baseline age was 12.5 years (IQR 8.4-15.8). Median follow-up was 14 months (IQR 7-22). The overall cumulative incidence of DTG initiation reached 22.7% (95% CI 21.3 to 24.2) and 56.4% (95% CI 54.4 to 58.4) at 12 and 24 months, respectively. In univariate analyses, those aged <5 years and female were overall less likely to switch. Adjusted on ART line and available viral load (VL) at baseline, females aged >10 years were less likely to initiate DTG compared with males of the same age (adjusted HR among 10-14 years: 0.62, 95% CI 0.54 to 0.72; among >= 15 years: 0.43, 95% CI 0.36 to 0.50), as were those with detectable VL (>50 copies/mL) compared with those in viral suppression (aHR 0.86, 95% CI 0.77 to 0.97) and those on PIs compared with those on non-nucleoside reverse-transcriptase inhibitors (aHR after 12 months of roll-out: 0.75, 95% CI 0.65 to 0.86). Conclusion Paediatric DTG uptake was incomplete and unequitable in west African settings: DTG use was least likely in children <5 years, females >= 10 years and those with detectable VL. Maintained monitoring and support of treatment practices is required to better ensure universal and equal uptake. | |
| dc.language.iso | EN | en_US |
| dc.rights | Attribution-NonCommercial 3.0 United States | * |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc/3.0/us/ | * |
| dc.subject.en | Cohort study | |
| dc.subject.en | HIV | |
| dc.subject.en | Paediatrics | |
| dc.subject.en | Public Health | |
| dc.title.en | Disparities in dolutegravir utilisation in children, adolescents and young adults (0-24 years) living with HIV. An analysis of the IeDEA Pediatric West African cohort | |
| dc.title.alternative | BMJ Glob Health | en_US |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1136/bmjgh-2024-016512 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
| dc.identifier.pubmed | 39809526 | en_US |
| bordeaux.journal | BMJ Global Health | en_US |
| bordeaux.volume | 10 | en_US |
| bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - UMR 1219 | en_US |
| bordeaux.issue | 1 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.institution | INSERM | en_US |
| bordeaux.team | GHIGS_BPH | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| bordeaux.identifier.funderID | Institut de Recherche pour le Développement | en_US |
| bordeaux.identifier.funderID | National Institutes of Health | en_US |
| hal.popular | non | en_US |
| hal.audience | Internationale | en_US |
| hal.export | false | |
| dc.rights.cc | Pas de Licence CC | en_US |
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