[686] EVALUATION OF A HAART PILOT STUDY IN YAOUNDE, CAMEROON: 24 MONTHS FOLLOW-UP

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] EVALUATION OF A HAART PILOT STUDY IN YAOUNDE, CAMEROON: 24 MONTHS FOLLOW-UP

[AUTHOR(S):] R Mougnutou¹, A Bourgeois^1,2, N Nkoue¹, C Laurent², B Lactouock¹, F Liégeois^1,2, L Ciaffi³, P Biason³, A Calmy³, E Mpoudi-Ngole¹ and E Delaporte²
R Mougnutou¹, A Bourgeois^1,2, N Nkoue¹, C Laurent², B Lactouock¹, F Liégeois^1,2, L Ciaffi³, P Biason³, A Calmy³, E Mpoudi-Ngole¹ and E Delaporte²

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 686
Antiviral Therapy 2003; 8(Suppl. 1):S373

[ABSTRACT:] Objective: To study the feasibility, effectiveness, adherence, toxicity and viral resistance in a prospective HIV-1 patients cohort, in Yaounde, Cameroon.

Methods: Parvy is a collaborative project based at the Military Hospital, providing HAART to HIV-1 patients. The first-line regimen is ZDV or d4T, 3TC and nevirapine. Other available drugs include ddI, efavirenz and nelfinavir. Clinical follow-up was done monthly. Viral load and CD4 count are determined at baseline and half-yearly.

Results: From January 2001 to January 2003, 117 patients (81 women) were recruited, all ART naïve except 1. The majority (96.5%) were HIV-1 group M (CRF02: 65.6%, A: 25%). The median age was 34 years (IQR 29–41). At baseline, 16, 50 and 51 patients were in CDC classes A, B and C, respectively; 85 (72.6%) had AIDS; the median BMI was 23.2 (IQR 21.3–25.2). The median CD4 cell count and viral load were 151/mm³ (IQR 61–223) and 213500 cop/ml (IQR 65,000–383,000), respectively. First-line regimen was given in 108 (92.3%) cases. Because of contraindications to nevirapine, ZDV or d4T and 3TC were associated with nelfinavir in five cases, efavirenz in four cases. The median length of follow-up was 10.5 months (IQR 5–17). After 12 months of HAART, the median CD4 cell count increased to 250/mm³ (IQR 173–411); viral load was undetectable (<400 cop/ml) in 85.2% of cases; the median BMI increased to 25.2 (IQR 22.9–27.8); the adherence was 100% in 89.5% of patients. Severe adverse effects occurred in 39 cases (28 cases of neutropenia without any repercussions); the others included hypertransaminasemia, anaemia, cutaneous eruption. 17 patients changed treatment because of tuberculosis (n=6), adverse effects (n=11) and NNRTI resistance (n=1). 9 (7.7%) patients died; the median time to death was 9 months (IQR 1–12).

Conclusion: Despite advanced disease stages and high genetic diversity, in this cohort benefiting from optimal standards of care, the results are similar to those in industrialized countries.

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