@article {FokamA58, author = {Joseph Fokam and Desire Takou and Maria Santoro and Armanda Nangmo and Samuel M Sosso and Georges Teto and Vittorio Colizzi and Carlo-Federico Perno and Alexis Ndjolo}, title = {PO 8580 TREATMENT RESPONSE AMONG CAMEROONIAN ADOLESCENTS RECEIVING ANTIRETROVIRAL THERAPY IN URBAN AND RURAL SETTINGS: PRELIMINARY FINDINGS FROM THE READY STUDY}, volume = {4}, number = {Suppl 3}, pages = {A58--A58}, year = {2019}, doi = {10.1136/bmjgh-2019-EDC.152}, publisher = {BMJ Specialist Journals}, abstract = {Background Transitioning from paediatric to adult healthcare requires successful antiretroviral treatment (ART) for adolescents living with HIV (ADLHIV). Implementing such a policy implies monitoring ART response and selecting for therapeutic options for ADLHIV in resource-limited settings (RLS) like Cameroon.Methods The Ready study (EDCTP-CDF-1027) is conducted amongst ART-experienced ADLHIV (10{\textendash}19 years old) in the Centre region, Cameroon. WHO-clinical staging, CD4-counts and viraemia were determined; in case of virological failure [VF] (viraemia >=1000 copies/ml), HIV drug resistance (HIVDR) and subtyping were performed, and p\<0.05 considered significant.Results Out of 279 ADLHIV (212 urban vs 67 rural), the gender distribution was similar (54.5\% female); median age was higher in urban (15 [IQR: 13{\textendash}17] years) compared to rural (13 [IQR: 11{\textendash}17] years), as well as the median duration on ART (7 [IQR: 3{\textendash}10] years compared to 4 [IQR: 2{\textendash}7] years, respectively); and the majority was on first-line ART (79.4\% [162/204] urban vs 98.5\% [66/67] rural, p\<0.0004). Following treatment response, clinical failure (WHO-stage 3/4) was similarly low in both urban (5.7\% [12/210]) and rural (4.5\% [3/67]), p=0.938; CD4 increased similarly (p=0.298) from ART-initiation (370 cells/mm3[urban] vs 332 cells/mm3[rural]) to 6 years after initiation (938 cells/mm3[urban] vs 548 cells/mm3[rural]) and rate of immunodeficiency (\<500 CD4 cells/mm3) was 41.0\% (87/208) in urban vs 47.5\% (29/61) in rural, p=0.428. VF was 43.2\% (41/95) in urban vs 60.9\% (14/23) in rural, p=0.126. Among nine (9) sequences available from those experiencing VF, overall HIVDR was found in 88.8\%, with 77.7\% NNRTI, 55.6\% NRTI and 22.2\% PI/r. All were HIV-1 group M, with 55.6\% CRF02_AG, 22.0\% F1 and 22.4\% others.Conclusion ADLHIV appear clinically asymptomatic, with considerable immune recovery overtime. Despite differences in ART duration between urban and rural settings, VF was similarly high, associated with HIVDR mainly to NNRTI-based regimens. Thus, NNRTI-sparing regimens might be highly convenient when transitioning ADLHIV to adult ART-regimens in RLS like Cameroon.}, URL = {https://gh.bmj.com/content/4/Suppl_3/A58.1}, eprint = {https://gh.bmj.com/content/4/Suppl_3/A58.1.full.pdf}, journal = {BMJ Global Health} }