ABSTRACT
Aims:We evaluated different treatment regimens administered to patients infected with HIV-2 in Mali, and studied pol polymorphisms that may influence susceptibility to antiretrovirals.Methodology:We collected 57 blood samples from HIV -2 seropositive patients in health centers in Mali (Bamako, Segou and Sikasso), including 21 treated patients and 36 untreated patients. The confirmation of the serological status and the measurement of the viral load were carried out in Brussels. Genotypic analysis of protease, reverse transcriptase and integrase was then performed on specimens with detectable viral load. The search for ARV resistance mutations and polymorphism positions was performed in comparison with reference sequences.Results:The most used treatment regimen was ZDV-3TC-LPV/ r. Genotypic analysis of protease, reverse transcriptase and integrase was performed on 20 samples from patients with detectable viral load: 16 untreated patients and 4 treated patients. Seventy-five percent of the strains analyzed correspond to group A of HIV-2. In 2cas, mutations associated with resistance to the administered molecules were found. Three viral strains from untreated patients had NRTI or PI resistance mutations. In integrase, no mutation associated with resistance was observed.Conclusion:The circulation of strains carrying resistance mutations to NRTIs and PIs has been observed in Mali
ABSTRACT
Background: There are few reports in the literature from sub-Saharan Africa (SSA) regarding antiretroviral-induced adverse drug reactions (ADRs). Antiretroviral therapy (ART) is now widely available in SSA, and ADRs during HIV infection are also frequent. In this study, we reported the frequency and risk factors of ART-induced ADRs in a Malian population.Methods: This prospective cohort study was performed in the HIV Care and Counseling Centre (CESAC) of Mali from 2011 to 2012. Adult patients infected with HIV and who had recently started ART were included and followed-up clinically Were included in this study, adult patients living with HIV and had recently started ART who were followed up for at least 6 months to determine the incidence of ADRs using Naranjo’s classification scale.Results: During this study, 357 (42.3%) patients presented ADRs (40.1% of our patients (n=338) experienced at least one ADR, and 2.2% (n=19) experienced at least two ADRs). The prevalence of ADRs by organ system was: 45.9% neurological (n=164); 29.4% metabolic (blood chemistry) (n=105); 15.4% hematological (n=55). High probable rate of ADR was observed as indicated by the Naranjo score in 83.7% of the cases. Zidovudine (AZT) and stavudine (d4T) use was identified as a risk factor for either anaemia or peripheral neuropathy whereas nevirapine (NVP) and female gender were risk factors for skin reactions. Patients with advance disease had the highest rate of ADRs compared to the others.Conclusions: Based on the Naranjo probability scale, our data show that ADRs such as peripheral neuropathy and anemia are very frequent. These ADR was linked to AZT and D4T. Our findings highlight the need for active monitoring, continuous pharmacovigilance of ART and change of some ART drug in this population.