[636] HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN BENIN INITIATIVE: WHAT HAVE BEEN USED AND FOR WHOM? LESSONS FROM 448 PATIENTS ELECTED ONE YEAR AFTER

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN BENIN INITIATIVE: WHAT HAVE BEEN USED AND FOR WHOM? LESSONS FROM 448 PATIENTS ELECTED ONE YEAR AFTER

[AUTHOR(S):] A Azondekon^1–3, I Zohoun², F Atadokpede¹, J De Souza², J Sehonou¹, E Deguenon², A Guedeme³ and A Gbaguidi³
¹Camp Guézo Army Teaching Hospital, Cotonou, Benin; ²Centre National Hospitalier et Universitaire, Cotonou, Benin; and ³National Program for AIDS Control, Cotonou, Benin

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 636
Antiviral Therapy 2003; 8(Suppl. 1):S359

[ABSTRACT:] Purpose of the study: The Benin National Program for AIDS Control has begun to deliver antiretroviral drugs for PLWA in advanced stage of the disease, since December 2001. The purpose of this study is to know the clinical, biological and immunological characteristics of patients who are receiving HAART and the proposed drug regimen.

Methods: Patients selected from December 2001 and February 2003, have their file reviewed. Data have been analysed in the SPSS software.

Lessons learned: Age: range from 19–58 years. Less than 30 years (23%), from 30–50 years (70%) and more than 50 years (7%) Sex: 53% were male. Delay from diagnosis to treatment: less than 6 months (56%), from 6 months to 1 year (14%), from 1 year to 2 years (18%) and more than 2 years (12%). Clinical aspects: patients were category B (63.6%), category C (36%) and category A (0.4%). Body Mass Index: BMI was less than 18.5 for 35%. The frequent opportunistic diseases were: wasting 86%; oral candidiasis 49%; dermatitis 46%; fever 40%; diarrhea 35%; cough/dyspnea 25%; oesophageal candidiasis 18%; zoster 8%; neurological complaints 8% and tuberculosis 4%. Immunological aspects: category 2 (9.5%) and category 3 (90.5%); none were category 1. From those who are immune category 3: 28% have CD4 less than 50/mm³; 30% have CD4 range from 50–100/mm³; and 42% have CD4 more than 100/mm³. Biological aspects: haemoglobin rate was less than 9 g/dl (14%), liver enzymes were high (10%). Virological aspects: 98.4% were HIV 1; 0.6% was HIV 2 and 1% was HIV 1 and 2. Regimen proposed: 55% have a regimen with one protease inhibitor (PI) and two nucleoside reverse transcriptase inhibitors (NRTIs); 45% a regimen with two NRTIs and one non-nucleoside reverse transcriptase inhibitor (NNRTIs). PIs available were nelfinavir and indinavir; NRTIs available were ZDV, 3TC, D4T and DDI; NNRTI available was EFV. ZVD was avoided in case of severe anaemia and the combination D4T plus DDI not recommended where peripheral neuropathy complaints exist.

Conclusions: Clinical and immunological aspects are those recommended by the CDC Atlanta. A look has to be taken to nutritional figures and specific nutritional needs must be addressed as integral in the Benin Initiative on Access to Antiretroviral Therapy. Special attention should be paid to opportunistic infection treatment. VCT should be reinforced because half of patients were diagnosed less than 6 months ago. The real challenge is the biological and immunological monitoring to control the regimen effectiveness and its side effects.

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