AEGiS-15IAC: Highly active antiretroviral therapy (HAART) in HIV- infected Africans: The question of optimal time to start.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Highly active antiretroviral therapy (HAART) in HIV- infected Africans: The question of optimal time to start.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10382)

Erhabor O, Ejele OA, Nwauche CA
Department of Haematology and Immunology University of Port Harcourt PMB 1 Choba , Port Harcourt, Nigeria

BACKGROUND: Highly active antiretroviral therapy (HAART) has changed the landscape of HIV related care in the developed world but its benefits have not been well elucidated especially among Africans. In this study, we have compared the immunological response to HAART in Africans based on starting baseline CD4 count.

METHODS: In this case control study, 70 HIV infected previously antiretroviral naïve Nigerians aged 19-58 years (33 females and 37 males) in 3 baseline CD4 count groups< 200, 200-350 and >350 cells/ul were placed on a short- term HAART of Stavudine, Lamivudine and Nevirapine for 8 weeks. 30 HIV-infected age and sex matched previously antiretroviral naïve patients yet to commence HAART were included as controls.

RESULTS: The mean absolute CD4 rise was 47,41 and 32 cells/ul respectively in subjects initiating HAART at baseline CD4 count of<200, 200-350 and >350 cells/ul. The mean AIDS defining CD4 count at baseline was 150.53 ±28.4. Adverse event of Steven Johnson's syndrome (rash) was seen in 4.3% of subjects. Mortality rate of 2.9% was observed in subjects on HAART and 13.3 % among untreated controls. Mortality was found clustered in patients initiating or deferring HAART at low baseline CD4 count of<200 cells/ul.

CONCLUSION: This study shows that bogus immunological response is possible in HIV- infected Africans initiating HAART with a baseline CD4 count of< 200 cellls/ul and that there is no immunological advantage in initiating HAART at a CD4 count of >350 cells/ul rather at a CD4 count of 200-350 cells/ul and< 200 cells/ul.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, HIV, Acquired Immunodeficiency Syndrome, HIV Seropositivity, CD4 Lymphocyte Count, HIV Infections, Nevirapine, HIV Protease Inhibitors, Disease Progression, Anti-HIV Agents, Time, Case-Control Studies, Humans, Female, Male

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B10382