AEGiS-13IAC: Virologic and immunologic response to antiretroviral therapy among patients participating in the UNAIDS/Ministry of Health initiative to improve access to therapy for HIV-infected persons in Cote d'Ivoire.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Virologic and immunologic response to antiretroviral therapy among patients participating in the UNAIDS/Ministry of Health initiative to improve access to therapy for HIV-infected persons in Cote d'Ivoire.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrB295)

Djomand G, Roels TH, Coulibaly M, Diomande F, Ebah L, Nkengasong J, Aka R, Monga B, Maurice C, Bissagnene E, Wiktor SZ, Chorba T
G. Djomand, Projet Retro - CI, 01 BP 1712, Abidjan 01, Cote D'ivoire, Tel.: +225 212 541 11, Fax: +225 212 429 69, E-mail: agd3@cdc.gov

BACKGROUND: In August 1998, a pilot program was started by UNAIDS and the Cote d'Ivoire Ministry of Health (MOH) to improve access to drug therapy for HIV infection, including antiretrovirals.

OBJECTIVE: To describe the types of antiretroviral regimens prescribed and the virologic and immunologic response to these therapies among patients participating in the UNAIDS/MOH initiative.

METHODS: For patients presenting at the participating centers, clinical information was collected using standard forms and a blood sample was drawn for lymphocyte subtyping (Facscan) and HIV plama viral load testing (Amplicor).

RESULTS: ARV were prescribed for a total of 491 adult patients, including 324 (66%) never previously treated (ARV-naive). Baseline median viral load was 5.2 log₁₀ copies/mL and median CD4 count was 110 cells/m l. Among ARV- naive patients, 43% were treated with 2 nucleoside reverse transcriptase inhibitors (2NRTI; AZT and ddI for 52%), 41% with highly active antiretroviral therapy (HAART), and 16% other combinations. Among ARV-naive patients on 2NRTI (monthly cost US$170), and HAART (US$460), 0.4% vs 25% achieved undetectable plasma virus levels after 12 months of follow-up, respectively. The changes from baseline in VL and CD4 count among ARV-naive patients are: Therapy 1 month 4 months 7 months 10 months 13 months Median VL HAART -3.0 -3.2 -3.5 -3.3 -4.0 (log₁₀ /mL) 2NRTI -2.5 -2.2 -1.5 +0.5 +1.5 CD4 count HAART 45 90 100 180 190 (cells/m l) 2NRTI 100 120 99 100 100

CONCLUSION: Among patients participating in the UNAIDS/MOH initiative, those on HAART had a more pronounced and sustained virologic and immunologic response than patients treated with 2NRTI. Since the principal barrier to the prescription of HAART is cost, measures are needed to reduce the cost of this type of therapy.

Keywords: AEGIS, HIV Infections, Antiretroviral Therapy, Highly Active, Viral Load, CD4 Lymphocyte Count, Reverse Transcriptase Inhibitors, HIV Seropositivity, Cote d'Ivoire, Adult, Human, virology, immunology, therapy, drug therapy
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