[Efficacy of highly active antiretroviral therapy alone in the treatment of diffuse lymphocytic infiltration syndrome in an ivorian patient living with HIV: a case report]. / Efficacité du traitement antirétroviral hautement actif seul dans le traitement du syndrome d'infiltration lymphocytaire diffus chez une patiente ivoirienne vivant avec le VIH : à propos d'un cas.

Objective: We report in this work the efficacy of highly active antiretrovirals (ARVs) alone in the treatment of diffuse infiltrative lymphocytosis syndrome (DILS) without the use of corticosteroids, which appears risky in patients living with HIV. Observation: This is a 60-year-old HIV-positive patient, discovered during the etiological workup of renal failure, which revealed a non-nephrotic glomerular profile. The renal biopsy found an interstitial infiltrate of CD8 suggestive of DILS. Management consisted in starting ARV treatment alone (lamuvidine, abacavir and raltegravir) without associated corticosteroid therapy. The clinical evolution under treatment was marked by a recovery of the renal function with a creatininemia at 99 µmol/l, a regression of the proteinuria, a CD4 rate at 293/mm3 and an HIV viral load at 533.3 copies or 1.6 log in the space of 3 months. Conclusion: DILS is a diffuse systemic disease in HIV patients who are usually under poor virological control. In view of the strong immunosuppression and the absence of other infiltrative diseases, it appeared to us to be risky and unjustified to add a corticosteroid therapy.

Effectiveness of the Treatment of Chronic Hepatitis C Virus Infection Genotype 2 by the Combination Sofosbuvir/Ledipasvir in a Black African Kidney Transplant.

The advent of direct-acting anti-virals revolutionized the treatment and prognosis of patients infected with hepatitis C. The interest of this presentation is to draw attention to the issue of therapeutic management posed by the hepatitis C virus in a kidney graft in Côte d'Ivoire, a resource-limited country where all the direct-acting anti-virals are not yet available. We report the case of a kidney transplant of 52 years old, chronic carrier of viral hepatitis C who presented after his kidney transplant in decompensated active cirrhosis. A treatment based on Sofosbuvir 400 mg/Ledipasvir 90 mg in this patient with genotype 2 for 12 weeks was initiated. Sustained virologic response 12 weeks and 24 weeks off therapy was observed. This is the first documented case of successful treatment of a genotype 2 viral C infection based on Sofosbuvir/Ledipasvir in a black African cirrhotic kidney transplant patient undergoing immunosuppressive therapy.