{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:09:43Z","timestamp":1793120983905,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T00:00:00Z","timestamp":1617148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["CDF TMA 1027"],"award-info":[{"award-number":["CDF TMA 1027"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Adolescents living with perinatal HIV infection (ALPHI) experience persistently high mortality rates, particularly in resource\u2010limited settings. It is therefore clinically important for us to understand the therapeutic response, acquired HIV drug resistance (HIVDR) and associated factors among ALPHI, according to geographical location.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A study was conducted among consenting ALPHI in two urban and two rural health facilities in the Centre Region of Cameroon. World Health Organization (WHO) clinical staging, self\u2010reported adherence, HIVDR early warning indicators (EWIs), immunological status (CD4 count) and plasma viral load (VL) were assessed. For those experiencing virological failure (VF, VL\u00a0\u2265\u00a01000 copies\/mL), HIVDR testing was performed and interpreted using the Stanford HIV Drug Resistance Database v.8.9\u20131.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 270 participants, most were on nonnucleoside reverse transcriptase inhibitor (NNRTI)\u2010based regimens (61.7% urban <jats:italic>vs<\/jats:italic>. 82.2% rural), and about one\u2010third were poorly adherent (30.1% <jats:italic>vs<\/jats:italic>. 35.1%). Clinical failure rates (WHO\u2010stage III\/IV) in both settings were\u00a0&lt;\u00a015%. In urban settings, the immunological failure (IF) rate (CD<jats:sub>4<\/jats:sub>\u00a0&lt;\u00a0250 cells\/\u03bcL) was 15.8%, statistically associated with late adolescence, female gender and poor adherence. The VF rate was 34.2%, statistically associated with poor adherence and NNRTI\u2010based antiretroviral therapy. In the rural context, the IF rate was 26.9% and the VF rate was 52.7%, both statistically associated with advanced clinical stages. HIVDR rate was over 90% in both settings. EWIs were delayed drug pick\u2010up, drug stock\u2010outs and suboptimal viral suppression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Poor adherence, late adolescent age, female gender and advanced clinical staging worsen IF. The VF rate is high and consistent with the presence of HIVDR in both settings, driven by poor adherence, NNRTI\u2010based regimen and advanced clinical staging.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13095","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T05:22:10Z","timestamp":1617254530000},"page":"567-580","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Alarming rates of virological failure and HIV\u20101 drug resistance amongst adolescents living with perinatal HIV in both urban and rural settings: evidence from the EDCTP READY\u2010study in Cameroon"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1501-2763","authenticated-orcid":false,"given":"J","family":"Fokam","sequence":"first","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences (FMSB) University of Yaound\u00e9 I Yaound\u00e9 Cameroon"},{"name":"National HIV Drug Resistance Working Group (HIVDRWG) Ministry of Public Health Yaound\u00e9 Cameroon"},{"name":"World Health Organisation Africa Multilingual Expert Laboratory Trained (MELT) group Brazzaville Congo"},{"name":"Faculty of Health Sciences (FHS) University of Buea Buea Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Takou","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Njume","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"},{"name":"Faculty of Health Sciences (FHS) University of Buea Buea Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Pabo","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"},{"name":"Faculty of Science (FS) University of Buea Buea Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6228-1114","authenticated-orcid":false,"given":"MM","family":"Santoro","sequence":"additional","affiliation":[{"name":"University of Rome Tor Vergata (UTV) Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A\u2010E","family":"Njom Nlend","sequence":"additional","affiliation":[{"name":"National Social Welfare Hospital (NSWFH) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Beloumou","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Sosso","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Moudourou","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Teto","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Dambaya","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Djupsa","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Tetang Ndiang","sequence":"additional","affiliation":[{"name":"National Social Welfare Hospital (NSWFH) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FN","family":"Ateba","sequence":"additional","affiliation":[{"name":"Mother\u2010Child Centre of the Chantal BIYA\u2019s foundation (MCC\u2010CBF) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SC","family":"Billong","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Biomedical Sciences (FMSB) University of Yaound\u00e9 I Yaound\u00e9 Cameroon"},{"name":"National HIV Drug Resistance Working Group (HIVDRWG) Ministry of Public Health Yaound\u00e9 Cameroon"},{"name":"Central Technical Group National AIDS Control Committee (NACC) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Kamta","sequence":"additional","affiliation":[{"name":"Mfou District Hospital (MDH) Mfou Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Bala","sequence":"additional","affiliation":[{"name":"Mbalmayo District Hospital (MDH) Mbalmayo Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Lambo","sequence":"additional","affiliation":[{"name":"Nkomo Medical Center (NMC) Nkomo Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Tala","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences (FMSB) University of Yaound\u00e9 I Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Chenwi Ambe","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences (FMSB) University of Yaound\u00e9 I Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ML","family":"Mpouel","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences (FMSB) University of Yaound\u00e9 I Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Cappelli","sequence":"additional","affiliation":[{"name":"National Research Council Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Cham","sequence":"additional","affiliation":[{"name":"World Health Organisation Africa Multilingual Expert Laboratory Trained (MELT) group Brazzaville Congo"},{"name":"Global Funds for the fight against AIDS, Malaria and Tuberculosis Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Ndip","sequence":"additional","affiliation":[{"name":"Faculty of Science (FS) University of Buea Buea Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Mbuagbaw","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences (FHS) University of Buea Buea Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Koki Ndombo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Biomedical Sciences (FMSB) University of Yaound\u00e9 I Yaound\u00e9 Cameroon"},{"name":"Mother\u2010Child Centre of the Chantal BIYA\u2019s foundation (MCC\u2010CBF) Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Ceccherini\u2010Silberstein","sequence":"additional","affiliation":[{"name":"University of Rome Tor Vergata (UTV) Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Colizzi","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"},{"name":"University of Rome Tor Vergata (UTV) Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u2010F","family":"Perno","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"},{"name":"World Health Organisation Africa Multilingual Expert Laboratory Trained (MELT) group Brazzaville Congo"},{"name":"University of Milan (UM) Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Ndjolo","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for research on HIV\/AIDS prevention and management (CIRCB) Yaound\u00e9 Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences (FMSB) University of Yaound\u00e9 I Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"UNAIDS.Fact sheet 2016Available athttp:\/\/www.unaids.org\/en\/resources\/factsheet(Geneva Switzerland) (accessed 12 august 2020)."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.20.1.21930"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0187566"},{"key":"e_1_2_8_5_1","unstructured":"WHO | HIV\/AIDS \/ WHO. Available athttp:\/\/www.who.int\/gho\/hiv\/en\/(accessed 6 December 2018)."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph5050378"},{"key":"e_1_2_8_7_1","unstructured":"unaids\u2010data\u20102018_en.pdf."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0188606"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2016.08.031"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3851\/IMP2320"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.4848"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0145536"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit115"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-137-5_Part_2-200209031-00001"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0064345"},{"key":"e_1_2_8_16_1","first-page":"e515","article-title":"Current scenario of HIV\/AIDS, treatment options, and major challenges with compliance to antiretroviral therapy","volume":"8","author":"Bhatti AB","year":"2016","journal-title":"Cureus"},{"key":"e_1_2_8_17_1","unstructured":"Cameroon_art_2015.pdf. Available athttps:\/\/aidsfree.usaid.gov\/sites\/default\/files\/cameroon_art_2015.pdf(accessed 20 May 2019)."},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.18.2.20076"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000264"},{"key":"e_1_2_8_20_1","unstructured":"Rapport_annuel_cnls_2016.pdf."},{"key":"e_1_2_8_21_1","unstructured":"(Enqu\u00eate) [Internet]. Journal du Cameroun. 2019. Available athttps:\/\/www.journalducameroun.com\/le\u2010taux\u2010de\u2010prevalence\u2010du\u2010vihsida\u2010est\u2010de\u20102 7\u2010au\u2010cameroun\u2010enquete\/(accessed 20 august 2020)."},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/0471458716"},{"key":"e_1_2_8_23_1","volume-title":"Global action plan on HIV drug resistance. 2018 progress report","author":"World Health Organisation","year":"2018"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-308"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0129210"},{"key":"e_1_2_8_26_1","first-page":"1","volume-title":"Consolidated guidelines on person\u2010centred HIV patient monitoring and case surveillance","author":"World Health Organization","year":"2017"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00705-011-0982-3"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0144057"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000448"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000473"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3372-6"},{"key":"e_1_2_8_32_1","unstructured":"WHO|Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection [Internet]. WHO. Available athttp:\/\/www.who.int\/hiv\/pub\/arv\/arv\u20102016\/en\/(accessed 18 December 2018)."},{"key":"e_1_2_8_33_1","unstructured":"World Health Organization.Global action plan on HIV drug resistance 2017\u20102021: 2018 progress report July 2018: executive summary. 2018; Available athttps:\/\/apps.who.int\/iris\/handle\/10665\/273049(accessed 22 May 2019)."},{"key":"e_1_2_8_34_1","unstructured":"WHO_Consolidated_Guidelines_Annexes_2.4.6.pdf [Internet]. Available athttps:\/\/www.who.int\/hiv\/pub\/guidelines\/WHO_Consolidated_Guidelines_Annexes_2.4.6.pdf?ua=1(accessed 22 May 2019)."},{"key":"e_1_2_8_35_1","unstructured":"Cameroon\u2010report.National Guidelines to the Prevention and Management of HIV\/AIDS in Cameroon [Internet]. Cameroon\u2010report.com. 2018. Available athttps:\/\/cameroon\u2010report.com\/sante\/national\u2010guidelines\u2010to\u2010the\u2010prevention\u2010and\u2010management\u2010of\u2010hiv\u2010aids\u2010in\u2010cameroon\/(accessed 20 May 2019)."},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41182-019-0135-z"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.18.1.20049"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001273"},{"key":"e_1_2_8_39_1","unstructured":"WHO|What\u2019s new in treatment monitoring: viral load and CD4 testing [Internet]. WHO. Available athttp:\/\/www.who.int\/hiv\/pub\/arv\/treatment\u2010monitoring\u2010info\u20102017\/en\/(accessed 22 May 2019)."},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.20.4.21475"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000348"},{"key":"e_1_2_8_42_1","unstructured":"Evolution of the immune system in humans from infancy to old age [Internet]. Available athttps:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4707740\/(accessed 29 May 2019)."},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofw233"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.19.1.20683"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2015-000004"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2016.0010"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002432"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000942"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0129210"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1991-3"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.13095","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T09:59:22Z","timestamp":1693303162000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.13095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,31]]},"references-count":49,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1111\/hiv.13095"],"URL":"https:\/\/doi.org\/10.1111\/hiv.13095","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,31]]},"assertion":[{"value":"2020-09-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}