Evolutionary Profile of Opportunistic Infections in People Living with Human Immunodeficiency Virus during Six Months of Dolutegravir Based Antiretroviral Treatment in Kinshasa, Democratic Republic of Congo

Background: Opportunistic infections (OI), which are still a major problem in the care of People Living with HIV (PLHIV), occur in situations of immunosuppression. The AntiRetroViral Treatments (ART) used allow a spectacular reduction in the frequency of Opportunistic Infections. Objective: The objective of this study is to present the evolution of Opportunistic Infections in People Living with HIV under AntiRetroViral Treatment in Kinshasa in the era of Dolutegravir. Methods: The present study is a prospective cohort to present the evolutionary profile of OIs in PLHIV on ART for 6 months in Outpatient Treatment Centers (OTC) in Kinshasa. Sixteen OTCs had been included. The population of the present work was patients over 18 years of age at inclusion, infected with HIV-1 and initiating ART in the selected OTC. Results: On inclusion, 119 patients were included of which 56.3% were women. Malaria (45.4%), tuberculosis (29.4%) and cutaneous pruritus (23.5%) were the most common Opportunistic Infections (OIs). In the third month of ART, 37 patients came for the consultation of which 70.3% were women. Non-specific STIs (97.3%), skin pruritus (37.8%) and malaria (24.3%) were the dominant OIs among patients. At the sixth month of ART, 62 patients came for the medical consultation of which 61.3% were women. Skin pruritus (25.8%), dermatitis (22.6%) and rash (21%) were the most common OIs. Conclusion: The evolutionary profile is marked by the conservation of Opportunistic Infections such as dermatitis (pruritus and rashes) and malaria.

Neurocognitive Profile of People Living with Human Immunodeficiency Virus Initiating Treatment in Kinshasa in the Dolutegravir Era, Democratic Republic of Congo

Context: Antiretroviral therapies improve the prognosis of NeuroAIDS contrasting with a high frequency of Minor Neurocognitive Disorders (MND) even in aviremic subjects. Objective: The objective of this study is to present the neurological and cognitive profile of People Living with HIV (PLHIV) initiating antiretroviral treatment in Kinshasa in the era of Dolutegravir (DTG). Methods: This is a multicenter, cross-sectional study with a descriptive aim carried out in 16 HIV Outpatient Treatment Centers (OTC) in Kinshasa from October 4, 2021 to February 15, 2022. The International HIV Dementia Scale (IHDS) correlated with the Activities of Daily Living (IADL) scale facilitated the categorization of NeuroCognitive Disorders (NCD) of PLHIV evaluated after carrying out a summary neurological examination. Results: Of the 96 patients recruited, 56.3% were women with a sex ratio of 0.68. The average age was 40.1 ± 12.1 years. The secondary education level was the majority at 64.6%. Malaria (44.8%) and tuberculosis (32.3%) were more common as opportunistic infections. They were alcoholics in (30.2%). Their history was heart disease (15.6%), high blood pressure (18.8%);drug abuse (10.4%). The IHDS score was light in 55.2% of cases. The correlation between IHDS/IADL watches asymptomatic neurocognitive impairments (ANI) in 77.1%, almost all of subjects are found with normal overall functioning (94.8%) and a disturbed neurological examination in 53.1% of cases with a predominance of motor impairments in 79.1%. Conclusion: In view of these results, early and systematic screening of NCD and associated factors remains necessary in our context. .

Clinical and Anthropometric Evolution of People Living with Human Immunodeficiency Virus during 6 Months of Dolutegravir Treatment in Kinshasa, Democratic Republic of Congo

Background: AntiRetroViral Treatment (ART) remains an important tool for reducing morbidity and mortality and improving the quality of life of people living with the Human Immunodeficiency Virus (PLHIV). Under the pressure of ART, several parameters of PLHIV change and are the subject of different evaluations. Objective: The objective of this work was to study the clinical and anthropometric evolution of PLHIV after 6 months of ART based on Dolutegravir (DTG). Methods: The present study was a non-interventional prospective cohort to assess the clinical and anthropometric evolution of PLHIV after 6 months of ART in the Ambulatory Treatment Center (CTA) for HIV in Kinshasa. The patients included were followed for 6 months in compliance with the schedule promulgated by the National Program. The parameters of interest were: Age, Sex, Marital Status, Weight, Height, Body Mass Index and Clinical Status. Results: On inclusion, 119 patients (56.3% women;43.7% men) were selected. During the consultation appointments, 42 patients (66.7% women;33.3% men) were present at M1, 37 patients (70.3% women;29.7% men) at M3, and 67 patients (61.3% women and 38.7% men) in M6. On inclusion, 41.5% of patients were at Stage 3 and 47.0% had a normal clinical condition. In M1, 48.7% of patients were at Stage 1 and 65.8% had a normal clinical condition. At M3, 41.7% of patients were at Stage 3 and 67.6% had a normal clinical condition. At M6, 61.8% of patients were at Stage 3 and 67.9% had a normal clinical condition. On D0, 45.5% of patients were in the 45 to 55 kg range and 56.5% had a normal Body Mass Index (BMI). At M1, 45.7% were in the 45 to 55 kg range and 50.0% had a normal BMI. At M3, 34.4% were in the 45 to 55 kg range and 64.3% had a normal BMI. At M6, 31.8% were in the range of 45 to 55 kg and, respectively, 37.5% of patients were lean and had a normal BMI. Conclusion: The clinical and anthropometric parameters evolve in saw tooth. Improvements are easily visible up to the third month of AntiRetroViral Treatment (ART). At the sixth month, with the pressure of the infection by the Human Immunodeficiency Virus (HIV), the evolution of the patients is compromised.