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Home >> Publications >> First-year lymphocyte T CD4+ response to antiretroviral therapy according to the HIV type in the IeDEA West Africa collaboration.

Publication

Author(s):

Drylewicz J, Eholie S, Maiga M, Zannou DM, Sow PS, Ekouevi DK, Peterson K, Bissagnene E, Dabis F, Thiê©baut R; International epidemiologic Databases to Evaluate AIDS (IeDEA) West Africa Collaboration.

Pub Title:

First-year lymphocyte T CD4+ response to antiretroviral therapy according to the HIV type in the IeDEA West Africa collaboration.

Pub Date:

Apr 24 2010

Pub Region(s):

West Africa

Journal Issue:

7

Page Number:
1043-50

Journal:

Title: 
AIDS
Link: 
http://journals.lww.com/aidsonline/pages/articleviewer.aspx?year=2010&issue=04240&article=00014&type=abstract

PubMed: 20397306
Pub PDF: PDF icon 20397306.pdf

Abstract
OBJECTIVE
: To compare the lymphocyte T CD4+ (CD4) response to combinations of antiretroviral therapy (ART) in HIV-1, HIV-2 and dually positive patients in West Africa.

DESIGN AND SETTING: Collaboration of 12 prospective cohorts of HIV-infected adults followed in Senegal (2), Gambia (1), Mali (2), Benin (1) and Côte d'Ivoire (6). Subjects: Nine thousand, four hundred and eighty-two patients infected by HIV-1 only, 270 by HIV-2 only and 321 dually positive, who initiated an ART.

OUTCOME MEASURES: CD4 change over a 12-month period.

RESULTS: Observed CD4 cell counts at treatment initiation were similar in the three groups [overall median 155, interquartile range (IQR) 68; 249 cells/microl). In HIV-1 patients, the most common ART regimen was two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI; N = 7714) as well as for dually positive patients (N = 135). HIV-2 patients were most often treated with a protease inhibitor-based regimen (N = 193) but 45 of them were treated with an NNRTI-containing ART. In those treated with a NNRTI-containing regimen, the estimated mean CD4 change between 3 and 12 months was significantly lower in HIV-2 (-41 cells/microl per year) and dually positive patients (+12 cells/microl per year) compared to HIV-1 patients (+69 cells/microl per year, overall P value 0.01). The response in HIV-2 and dually positive patients treated by another regimen (triple NRTIs or protease inhibitor-containing ART) was not significantly different than the response obtained in HIV-1-only patients (all P values >0.30).

CONCLUSION: An optimal CD4 response to ART in West Africa requires determining HIV type prior to initiation of antiretroviral drugs. NNRTIs are the mainstay of first-line ART in West Africa but are not adapted to the treatment of HIV-2 and dually positive patients.

PMID: 20397306 [PubMed - indexed for MEDLINE]

PMCID: PMC2880184

 

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Citation:

Drylewicz J, Eholie S, Maiga M, Zannou DM, Sow PS, Ekouevi DK, Peterson K, Bissagnene E, Dabis F, Thiébaut R; International epidemiologic Databases to Evaluate AIDS (IeDEA) West Africa Collaboration. First-year lymphocyte T CD4+ response to antiretroviral therapy according to the HIV type in the IeDEA West Africa collaboration. AIDS. 2010 Apr 24;24(7):1043-50. PubMed PMID: 20397306; PubMed Central PMCID: PMC2880184.