Therapeutic status of HIV-infected patients with at least 5 years of follow-up for antiretroviral therapy in a resource-limited setting: the experience of the CNHU ambulatory treatment center in Cotonou, Benin.

OBJECTIVES: The aim of this study was to describe the therapeutic situation of patients who had been followed up for antiretroviral therapy for at least 5 years. PATIENTS AND METHODS: A retrospective and descriptive study reviewed records of the historical cohort of adults infected with HIV in the national and teaching hospital at Cotonou from January 2, 2002, to March 31, 2013. It included all patients with follow-up for ART for at least five years. Immunological success was defined as a CD4 count above 350 cells/µl at the last test during the study period, and therapeutic success by viral load determined to be undetectable at its last measurement. Data were extracted from the updated ESOPE. STATA 11 software was used for data analysis. RESULTS: In March 2013, 979 patients, accounting for 27.1% of the overall cohort at the site, had been followed up for at least 5 years for ART. Their mean age was 38.1 ± 9.6 years and the sex-ratio (M/F) was 0.7. Analysis showed that 12.3% had been lost to follow-up, 2.3% had died, and 83.6% remained in treatment. The mean CD4 count at treatment initiation was 113.4±90.7 cells/µl, at 5 years 566.6±355.2 cells/µl, and at 10 years, 557.5±311.2 cells/µl. More than half (56.1%) of patients were treated with a first-line ART combination. Immunological success was reported for 63.2% of the patients. Of the 144 patients with a last viral load available, the therapeutic success rate was 76.4%. The probability of survival was 0.95 at 5 years and 0.91 at 10 years. CONCLUSION: Improving the quality and continuity of care can help to ensure short-term survival for PLHIV under a first-line ART treatment in resource-limited countries.

[Prevalence of peripheral artery disease among diabetics in Parakou in 2013]. / Prévalence de l'artériopathie oblitérante des membres inférieurs et facteurs associés chez les diabétiques suivis en milieu hospitalier à Parakou en 2013.

We aimed to determine the prevalence of peripheral artery disease and its associated factors among diabetics. The cross-sectional study was conducted and included all diabetics admitted to the diabetic clinic at the Parakou University hospital during the period of 1st February and 31st July 2013. The diagnosis of peripheral artery disease was based on the Ankle Brachial Index (ABI)<0.9. The socio-demographics data, the data concerning the diabetes and its complications were recorded in each patient. They were 401 diabetics and 59.5 % were females. The mean age was 53.7±11.5 years. Among the diabetics, 168 fulfilled the criteria of PAD, the overall prevalence was 41.9 %. In total, 31.5 % were symptomatics according to Leriche and Fontaine classification. The main associated factors were the increase of age (P=0.01), the absence of activity with high income (P=0.004), the absence of physical activity (P=0.023), the duration of diabetes (P=0.007), the presence of peripheral neuropathy (P=0.003), the glycosylated hemoglobin≥7 % (P<0.001). After a multivariate analysis, only diabetes control was independently associated with arteriopathy (P=0,004). The PAD was more frequent among diabetics in Parakou. The associated factors must be taken into account in order to improve the management of the disease and to reduce the burden of the PAD.