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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
The Senegalese government's highly active antiretroviral therapy initiative: An 18-month follow-up study
AIDS, Volume 16, No. 10, Year 2002
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Description
Objective: To study the feasibility, effectiveness, adherence, toxicity and viral resistance in an African government HAART initiative. Methods: A prospective observational cohort study started in Dakar in August 1998. Initial treatment consisted of two nucleoside reverse transcriptase inhibitors and one protease inhibitor. The patients attended monthly medical examinations. Plasma HIV-1 RNA and CD4 cell counts were determined at baseline and every 6 months. Intention-to-treat analyses were performed. Results: Fifty-eight treatment-naive patients, mostly infected by HIV-1 strain CRF02-AG, were enrolled. Most were at an advanced stage of HIV disease (86.2% had AIDS). Adherence was good in 87.9% of patients and treatment was effective in most of them. Thus, HIV-1 RNA was undetectable in 79.6, 71.2, 51.4 and 59.3% of patients at months 1, 6, 12 and 18, respectively and the median viral load reduction was ∼2.5 log10 copies/ml. The CD4 cell count rose by a median of 82, 147 and 180 × 106 cells/l at months 6, 12 and 18, respectively. At the same time points, the cumulative probability of remaining alive or free of new AIDS-defining events was 94.8, 85.0 and 82.3%. Most adverse effects (80.8%) were mild or moderate and only two cases of drug resistance occurred. Conclusion: This study shows that HAART is feasible and well tolerated in African patients. Clinical and biological results were comparable to those seen in western cohorts, despite differences in the HIV-1 subtype distribution and an advanced disease stage when the treatment was initiated. Contrary to other recent studies in Africa, viral resistance rarely emerged. © 2002 Lippincott Williams & Wilkins.
Authors & Co-Authors
Laurent, Christian
France, Montpellier
Université de Montpellier
Diakhaté, Ndella D.
Senegal, Dakar
Fann University Teaching Hospital
Fatou Ngom Gueye, Ndeye
Senegal, Dakar
Fann University Teaching Hospital
Awa Touré, Mame
Senegal, Dakar
Fann University Teaching Hospital
Salif Sow, Papa
Senegal, Dakar
Fann University Teaching Hospital
Awa Faye, Mame
Senegal, Dakar
Fann University Teaching Hospital
Guèye, Mandoumbé
Senegal, Dakar
Military Hospital
Laniéce, Isabelle
France, Montpellier
Université de Montpellier
Touré-Kâne, Coumba
Senegal, Dakar
Le Dantec University Teaching Hospital
Liégeois, Florian
France, Montpellier
Université de Montpellier
Vergne, Laurence
France, Montpellier
Université de Montpellier
Mboup, Souleymane
Senegal, Dakar
Le Dantec University Teaching Hospital
Badiane, Salif
Senegal, Dakar
Fann University Teaching Hospital
Ndoye, Ibrahima
Senegal, Dakar
National Aids Program
Delaporte, Éric
France, Montpellier
Université de Montpellier
France, Montpellier
Ird Centre de Montpellier
Statistics
Citations: 301
Authors: 15
Affiliations: 6
Identifiers
Doi:
10.1097/00002030-200207050-00008
Research Areas
Infectious Diseases
Study Design
Cohort Study
Study Approach
Quantitative