[Laboratory testing including CD4 T-cell count and determination of viral load to evaluate the impact of first line antiretroviral treatment at 6 months in adults in Benin]. / Evaluation de l'efficacité du traitement anti-rétroviral par analyse des charges virales au Bénin.
Med Trop (Mars)
; 70(1): 100, 2010 Feb.
Article
em Fr
| MEDLINE
| ID: mdl-20337131
ABSTRACT
The purpose of this study was to determine lymphocyte CD4 T-cell count and circulating HIV-1 RNA load in HIV-infected adults starting first line antiretroviral treatment according to the revised 2006 WHO recommendations in Cotonou, Benin. A total of 1209 adults treated mainly by lamivudine/stavudine/nevirapine, were prospectively included between November 2006 and June 2007. CD4 T-cell counts and HIV viral load (measured by branched DNA assay, Siemens, Tarytown, New York, USA) were evaluated at 6 months of treatment. Mean CD4 T-cell count showed a marked increase at six months of treatment (93/mm3 at baseline versus 387/mm3 at 6 months) with 65.2% of patients reaching a CD4 T-cell level higher than 200/mm3 and 34.8% showing CD4 T-cell counts lower than 200/mm3. At 6 months, HIV 1 viral load was undetectable (<2.70 log10 copies/ml) in only 54 patients (16.7%), detectable but lower than 3.0 log10 copies/ml in 522 (73%) patients, and high, i.e., still greater than 3.7 log10 copies/ml in 188 (27%) patients. After 18 months of follow up, 499 patients (41.3%) had undetectable circulating viral load. The three main findings of this study are that at 6 months of antiretroviral treatment i) one-third of patients remained at risk for opportunistic infection (CD4<200/mm3), ii) one-fourth met criteria for virological failure (> 5000 copies/ml), and iii) concordance between immunological and virological responses was frequent but discordance responses were observed in more than 10% of patients. Taken together, these findings underline the need to improve compliance and laboratory follow-up in patients undergoing antiretroviral therapy in Africa.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Contagem de Linfócito CD4
/
Carga Viral
/
Antirretrovirais
Tipo de estudo:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
País/Região como assunto:
Africa
Idioma:
Fr
Revista:
Med Trop (Mars)
Assunto da revista:
MEDICINA TROPICAL
Ano de publicação:
2010
Tipo de documento:
Article