[Evaluation of antiretroviral treatment in a cohort of 1,620 HIV-infected patients in Togo]. / Évaluation du traitement antirétroviral de 1 620 personnes infectées par le VIH au Togo.

PURPOSE: The purpose of this study was to evaluate the efficacy of antiretroviral treatment for HIV-infected patients in Togo. PATIENTS AND METHOD: This retrospective study covered the period from January 2001 to January 2009 and included all HIV-infected patients who received antiretroviral therapy for at least 12 months. RESULTS: The study included 1,620 of the 8,901 patients (18.2%) treated with antiretroviral therapy. Mean patient age was 34.8 ± 11.4 years and the male/female sex-ratio was 0.4. When treatment began, the mean CD4+ T lymphocyte count was 143/mm(3) and mean patient weight was 53.3 kg. Overall, 263 of the 1,620 subjects (16.2%) had opportunistic infections before starting antiretroviral treatment. The most frequently used antiretroviral combination was stavudine/lamivudine/nevirapine (91.7%). The compliance rate for the first 12 months was 89.6%, and the antiretroviral regimen was changed in 5.9% of cases. After 36 months, mean weight gain was 8.8 kg and the mean increase in the CD4(+) T lymphocyte count was 265 cells/mm(3). The number of opportunistic infections decreased from 263 cases at the beginning of antiretroviral treatment to 9 after three years of treatment. During follow-up, 258 deaths were recorded, for a cumulative case fatality rate of 15.9%. The most common side effects were cutaneous toxicity and anemia in the short term and neurological toxicity, lipodystrophy and hepatotoxicity over the long term. DISCUSSION: This study confirms the efficacy of antiretroviral treatment of HIV-infected patients in Togo. These findings should encourage policy-makers to work toward universal access to antiretroviral treatment for people living with HIV.

[Management of a case of unilateral exophthalmos due to an intraorbital lipofibroma at Kara teaching hospital in Togo]. / Prise en charge d'un cas d'exophtalmie unilatérale due à un lipofibrome intra-orbitaire au CHU de Kara au Togo.

In childhood, benign tumors are uncommon causes of exophtalmos. We report a case of intraorbital lipofibroma in an 11-year-old girl who presented with painless, progressive proptosis of the right eye over the preceding 6 months. Ultrasound had shown an extraconal intraorbital mass. Complete excision and pathologic examination were performed, revealing a lipofibroma with no signs of malignancy This case report is notable due to the rarity of the condition.

[Biological profile of adult patients infected with HIV at initiation of antiretroviral therapy in Togo]. / Profil biologique des patients adultes infectés par le VIH à l'initiation du traitement antirétroviral au Togo.

OBJECTIVE: The study's objective was to determine the CD4 count and laboratory abnormalities in adults infected with HIV at initiation of antiretroviral therapy (ART) in Togo. METHODS: A retrospective and descriptive study was made of all patients on HAART in 2009 in Togo. RESULTS: A total of 5106 patients were included with a median age of 35 years. 68.6% were female patients. HIV1 infection was predominant (97.5%). The mean CD4) count at treatment initiation was 134 cells/µl. Among these patients, 22.1% had a CD4 count below 50 cells/µl and 73.8% had a CD4 count below 200 cells/µl. The median hemoglobin level was 10.4 g/dl. Transaminase level was elevated (grade 1 and above) in 55.9% of patients for AST, and in 29.8% of patients for ALT. Mean serum creatinine was 9.6 ± 5 mg/l. CONCLUSION: Initiation of ART is late in Togo, consequently a significant proportion of patients present with severe immunosuppression on initiation of treatment. Improving strategies for mass screening should increase the number of patients treated early to better meet WHO 2009 recommendations.