Abstract

E-mail Abstract Author Add To Itinerary Session Search Abstracts Program

Session 65 Poster Session Antiretroviral Chemotherapy in Resource Limited Settings Session Time: 4:30-6:30 pm Room 4E-F

460-W. The Senegalese Government HAART Initiative: An 18-Month Follow-Up Study of Feasibility, Effectiveness, Adherence, Toxicity and Viral Resistance C. Laurent1, N. Diakhate2, N. Fatou Ngom2, P. Sow2, M. Faye2, M. Gueye3, I. Lanièce1, C. Toure Kane4, F. Liegeois1, S. Mboup4, S. Badiane4 , I. Ndoye5, and E. Delaporte*1 1IRD and Univ.of Montpellier, France; 2Fann Univ. Hosp., Dakar, Senegal; 3Military Hosp., Dakar, Senegal; 4Le Dantec Univ.Hosp., Dakar, Senegal; and 5Natl. AIDS Program, Dakar, Senegal. Background: Our objective was to study feasibility, effectiveness, adherence, toxicity, and viral resistance in an African government HAART initiative. Methods: A prospective observational cohort study was started in Dakar in August 1998. Initial treatment consisted of 2 NRTIs and 1 PI. The primary endpoint for efficacy was a reduction in plasma HIV-1 RNA to below the detection limit. Change in the CD4 cell count were analyzed using Wilcoxon's test. Data were analyzed on an intention-to-treat and "tritherapy received" basis. Changes in adherence with time was assessed using a logistic repression model for repeated data. Genotypic viral resistance was also studied. Results: 58 treatment-naïve patients, most infected by HIV-1 strain CRF02-AG, were enrolled. The mean CD4 cell count was 108/mm3 and the mean viral load was 106 400 copies/mL. Adherence was good in 87.9% of patients. HIV-1 RNA was undetectable in more than 80% of patients one month after treatment outset, and in 57.7% of patients at month 18. CD4 cell counts rose by a mean of 82, 151 and 180/mm3 at months 6, 12, and 18, respectively. Seven clinical AIDS-defining events occurred during follow-up. A total of 46 adverse effects were reported, and most were mild or moderate. 2 cases of drug resistance occurred. The cumulative probability of remaining alive or free of new AIDS-defining events was 94.8% at 6 months and 82.3% at 18 months. Conclusions: 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 reports in Africa, viral resistance rarely emerged.

©2002 9th Conference on Retroviruses and Opportunistic Infections