Immuno-virologic dissociation in patients infected by HIV-1 under antiretroviral treatment at the Day hospital of Bobo-Dioulasso from 2008 to 2012 (Burkina Faso)

• Published in: Le Mali medical Vol. 30; no. 4; p. 58
• Main Authors: Ouedraogo, S M, Zoungrana, J, Sondo, K A, Kyelem, C G, Koussé, S, Hema, A, Kaboré, F N, Soré, I, Bado, G, Sawadogo, A B
• Format: Journal Article
• Language: French
• Published: Mali 2015
• Subjects: Discordant Immunologic and Virologic Responses; Dissociation immuno-virologique; HIV; VIH; ARV; TARV; Bobo-Dioulasso
• ISSN: 1993-0836

describe the sociodemographic, clinical, therapeutic, biological profile and the observance of treatment in cases of immuno-virologic dissociation response (IVDR) in HIV-1 patients at te 12 months of antiretroviral treatment (ARVT). This was a historical cohort study with a descriptive and analytical focus from January 2008 to December 2012; covering the IVDR cases at the day hospital of Bobo Dioulasso. We collected the data during medical consultations by means of the ESOPE software and from medical records of the patients. Of 2078 patients on ARVT, 84 or 4% presented one IVDR, among which 56 women (66.7%) and 28 men (33.3%). The average age was 45 years [range: 45-55 years]. At the initiation of ARVT, most patients were in clinical stage 3 or 4 of the WHO classification (57.1%). The body mass index (BMI) average was 20.5kg/m [IQR = 18.5 and 23]. The average number of +CD4 T lymphocyte was 42 cells/mm [IQR = 12- 63]. During follow-up, the median gain in BMI was 3.2 kg/m [IQR = 1.2 to 4.3 kg/m ], the median gain was 76 cells/µl [IQR = 60 - 88]. The viral plasmatic load of the HIV-1 was undetectable with a rate of TCD4+ < 100 cells /µl in 12 months. Factors associated with IVDR were the age between 35 and 45 years (p = 0.0009), the number of +CD4 T cells (+CD4T≤50) at initiation of ARVT (p = 0.00045 ) and the WHO classification clinical stage 3. This study demonstrates the problem of IVDR management in Bobo-Dioulasso and reminds of the interest of care follow-up of people living with HIV-1 by viral load and not only by the rate of CD4+ T especially in the decentralized structures of coverage of HIV, where changes of therapeutic mechanisms operate disjointedly.