Epidemiology of Second-Line Antiretroviral Therapy Use in a Decentralized HIV Care Center in Senegal: A Retrospective Cross-Sectional Study (2019 – 2023)

Background: Human immunodeficiency virus (HIV) drug resistance necessitates second-line antiretroviral therapy (ART) in resource-limited settings. This study assessed the epidemiology of second-line ART use in a decentralized Senegalese HIV care center. Patients and Methods: A retrospective cross-sectional study (2019-2023) included 400 records of PLHIV from Cardinal Hyacinthe Thiandoum Health Center. Data on sociodemographics, clinical parameters, and ART history were analyzed using SPSS. Results: Among 400 PLHIV, 20 (5.0%, 95% CI: 4-6%) required second-line ART. Most of them were women (80%), mean age of 58.5±15.5 years. The main switch reasons were treatment failure (55%) and intolerance (45%). Mean viral load pre-switch was 68,387±15,879 copies/mL; mean CD4 count was 293±60 cells/μL. All patients received AZT+3TC+LPV/r. Conclusion: In this cohort of 400 patients followed at the Cardinal Hyacinthe Thiandoum Health Center, we observed that targeted therapeutic education was associated with fewer switches to second-line ART, potentially conserving resources for more complex cases. Decentralized HIV care with reinforced therapeutic education may reduce second-line ART needs, preserving resources for complex cases.