RESUMO
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.
Assuntos
Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Adulto , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/sangue , Humanos , Masculino , Estudos Retrospectivos , TogoRESUMO
The Psychopharmacological Studies Group of Fann, Dakar, considered the cultural expression of mental illness as it would help for a new definition of the nosographic frames, and inside of them, the appreciation of symptoms. This new definition would be applied "universally" if it may be considered that some symptoms are "culture-free" and others deeply marked by the discourse held by the person or by his social group. The use of valuation scales for symptomatic change during a treatment (here anti-depressive one) become harder by the undifferenciation of these two types of symptoms. Further, it may exist nosographic masks which can hide more curable substructures ; as often happens here, in masked depressions when the presented symptoms are those of acute or chronic psychotic manifestations. The efficacy of depressive treatment is then remarkable.
