[Mitochondrial toxicity: a case of palpebral ptosis in a woman infected by HIV and treated with HAART including zidovudine]. / Toxicit mitochondriale: cas d'un ptosis palpebral de l'oeil gauche chez une patiente infectée par le VIH sous trithérapie antirétrovirale comportant de l'AZT.

The usual clinical feature of mitochondrial toxicity is proximal myopathy. We present the report case of palpebral ptosis which occurred under zidovudine therapy The symptom remission was obtained by stopping the antiretroviral therapy. This involves an important vigilance from both doctor and patient.

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 and factors associated with cryptococcal antigenemia in HIV-infected patients in Cotonou/Benin]. / Prévalence de l'antigénémie cryptococcique et les facteurs associés chez les patients infectés par le VIH à Cotonou au Bénin.

OBJECTIVE: Determine the prevalence of cryptococcal antigenemia and associated factors in HIV-infected patients in Cotonou in order to introduce systematic screening in national guidelines. PATIENTS AND METHODS: This is a cross-sectional, descriptive and analytical study conducted from June to September 2015 in four outpatient treatment centers with adult patients infected with HIV, receiving or not antiretroviral treatment with a number of CD4≤200cell/µL and who have given their informed consent to participate in the study. For each enrolled patient, after signing the informed consent form, it was made a clinical examination and administration of a questionnaire to collect general information, treatment and biological data. Then a blood sample for counting CD4 lymphocytes and the search of cryptococcal antigenemia were done. RESULTS: In total, 355 patients were included in the study with a mean age of 40±10.2years. The overall prevalence of cryptococcal antigenemia is 1.7%. All patient with cryptococcal antigenemia have a CD4 count below 100cells/µL with a majority having CD4 count below 50cells/µL. Body mass index<18.5kg/m2, an alteration of the general condition with a CD4 lymphocyte counts<50cells/µL are the main factors associated with the occurrence of cryptococcal antigenemia. CONCLUSION: This pilot study showed a low prevalence of cryptococcal antigenemia in the study population, but higher in highly immuno-deficient patients with CD4 counts<50cells/µl. Given the results obtained, the introduction of routine screening among patients infected with HIV could be reserved to those with CD4 counts<50cells/µl.