16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

TUBERCULOSIS INCIDENCE AND RISK FACTORS AMONG ADULT PATIENTS RECEIVING HAART IN SENEGAL: A 7-YEAR COHORT STUDY

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. MoAb0104

Diouf A.¹, Etard J.-F.², Ndiaye I.³, Ngom Guèye N.F.⁴, Guèye P.M.⁵, Ba Fall K.⁵, Thierry-Mieg M.², Dieng A.B.¹, Cilote V.⁶, Lanièce I.⁶, Christian L.², Sow P.S.³, Ndoye I.⁶, Delaporte E.², ANRS 1290
¹Centre Hospitalier National de Fann, Centre régional de recherche et de formation VIH/sida-ANRS, Dakar, Senegal, ²Institut de Recherche pour le Développement, UMR 145, Montpellier, France, ³Centre Hospitalier National de Fann, Service des maladies infectieuses, Dakar, Senegal, ⁴Centre Hospitalier National de Fann, Centre de traitement ambulatoire, Dakar, Senegal, ⁵Hopital Principal de Dakar, Service Jamot, Dakar, Senegal, ⁶Conseil National de Lutte contre le Sida, Dakar, Senegal

BACKGROUND: Tuberculosis is a leading cause of death among HIV-1 infected adults receiving HAART in Senegal.

METHODS: Tuberculosis incidence was assessed in the patients enrolled between August 1998 and April 2002 in the Senegalese antiretroviral drug access initiative. Patients were included according to the consensus reports on HAART in Africa issued in 1997 and 2000. First-line regimen combined two NRTIs and either a NNRTI or a PI. Follow-up visits were done every two months with a complete biological assessment every six months. Cases of tuberculosis were ascertained by examining the patient clinical files. Survival analysis were performed.

RESULTS: 397 patients (54.7% women) were enrolled in the study and were followed for a median of 46 months (interquartile range: 32-57 months) after HAART initiation for a total of 1403 person-years as of September 30, 2005. At baseline, 5% were ART non-naïve, 39% and 55% were respectively at CDC stage B and C, median age, CD4 count and viral load were respectively 37 years, 128 cells/µL and 5.2 log cp/mL. More than a fourth of the patients had a previous history of tuberculosis and 47 incident cases of tuberculosis were recorded after HAART initiation, yielding to an overall incidence rate of 3.2/100 person-years [95%CI 2.4 - 12.4]. Incidence rate decreased with time after starting HAART from 6.4/100 person-years [4,2–9,6] for the first year to 3.5 [1.9-6.3] for the second year and 1,4/100 person-years [0,5-3.7] for the third year. It was associated with anaemia at baseline (haemoglobin level < 10 g/dL).

CONCLUSIONS: This study provides the first estimates of tuberculosis incidence following HAART initiation in Senegal.

2006-08-13
MoAb0104

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