Inmagic CS/WebPublisher PRO found 963 records

Your search found 963 record(s).
New Basic Search | New Advanced Search | POPLINE Document Delivery Policy

Subscription may be needed for full text

Title: Virologic and immunologic responses to antiretroviral therapy among HIV-1 and HIV-2 dually infected patients: case reports from Abidjan, Cote d'Ivoire.
Author: Borget MY; Diallo K; Adje-Toure C; Chorba T; Nkengasong JN
Source: Journal of Clinical Virology. 2009 May;45(1):72-5.
Abstract: In four of five HIV-1 and HIV-2 dually infected patients treated with efavirenz-based therapy, viral load was undetectable for HIV-1 only, with limited increase in CD4+ counts. Both viral loads were undetectable and CD4+ counts increased in one patient treated with protease inhibitor regimen. Specific guidelines for treating HIV-dually infected patients are needed that should avoid the use of non-nucleoside reverse transcriptase inhibitors.
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | CASE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HIV | INFECTIONS | ANTIRETROVIRAL THERAPY | CONTRACEPTIVE USE-EFFECTIVENESS | LABORATORY PROCEDURES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Contraceptive Effectiveness | Contraception | Family Planning | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342661

Title: [Contraceptive use and incidence of pregnancy among women after HIV testing in Abidjan, Ivory Coast] Pratiques contraceptives et incidence des grossesses chez des femmes apres un
Author: Brou H; Viho I; Djohan G; Ekouevi DK; Zanou B; Leroy V; Desgrees-du-Lou A
Source: Revue d'Epidemiologie et de Sante Publique. 2009 Mar 20;
Abstract: BACKGROUND: Within the framework of programs for the prevention of mother-to-child HIV transmission, women who discover their HIV-infection during their pregnancy receive perinatal interventions in order to reduce the risk of HIV transmission to the child. They also receive family planning counselling and free contraceptives in order to avoid a new pregnancy. In this study, we compared contraceptive use and pregnancy incidence between HIV-positive and HIV-negative women who were offered HIV counselling and testing during a program of prevention of mother-to-child HIV transmission. METHODS: In the Ditrame Plus program in Abidjan, 546 HIV-positive and 393 HIV-negative women were HIV-tested prenatally and followed up 2years after delivery. At each post-partum visit, proportions of contraceptive use were noted, by method. The pregnancy incidence was calculated as the number of pregnancies for 100 women-years at risk. Factors related to the arrival of a new pregnancy were analyzed by Cox model. RESULTS: Between 6 and 24 months post-partum, proportions of women using modern contraception varied from 52 to 65% among HIV-positive women, and from 65 to 75% among HIV-negative women. Pregnancy incidence for 100 women-years at risk was 5.70 (95%CI: 4.17-7.23) and 4.37 (95%CI : 2.83-5.91) (p=0.237) and unwanted pregnancy incidence was 1.07 (95%CI: 0.41-1.73) and 2.39 (95%CI: 1.25-3.53) (p=0.023), respectively among HIV-positive and HIV-negative women. The end of post-partum abstinence, the death of the index child and the end of breastfeeding were positively linked to the arrival of a new pregnancy in the post-partum period. CONCLUSION: Among these women prenatally HIV-tested, family planning counselling and regular follow-up was accompanied by a high rate of contraceptive use after delivery, and consecutively to a low pregnancy incidence irrespective of serostatus. In particular, HIV-positive women had fewer unwanted pregnancies than HIV-negative women. Integration of adequate family planning services in the post-partum follow-up in prevention programs plays an important role in reducing the risk of mother-to-child transmission, by reducing pregnancies among HIV-positive women.
Language: French
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | INCIDENCE | PREGNANCY | WOMEN | HIV TESTING | CONTRACEPTIVE USAGE | CLINIC VISITS | VOLUNTARY COUNSELING AND TESTING | POSTPARTUM | FAMILY PLANNING | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Reproduction | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Service Statistics | Program Activities | Programs | Organization and Administration | Puerperium | Program Evaluation
Document Number: 330856

Peer Reviewed

Title: Two-months-off, four-months-on antiretroviral regimen increases the risk of resistance, compared with continuous therapy: A randomized trial involving West African adults.
Author: Danel C; Moh R; Chaix ML; Gabillard D; Gnokoro J; Diby CJ; Toni T; Dohoun L; Rouzioux C; Bissagnene E; Salamon R; Anglaret X
Source: Journal of Infectious Diseases. 2009 Jan 1;199(1):66-76.
Abstract: A randomized trial was launched in Côte d'Ivoire in 2002 to compare continuous antiretroviral treatment (hereafter, "C-ART") to an ART regimen of 2 months off and 4 months on therapy (hereafter, "2/4-ART"). We report the final analysis. A total of 435 adults who were receiving successful ART ((median CD4 cell count prior to ART, 272 cells/mm3; 88% were receiving a zidovudine-lamivudine-efavirenz regimen) were randomized to receive C-ART or 2/4-ART. The main primary end point was the percentage of patients with <350 CD4 cells/mm3 at 24 months. The sample size ensured 80% power to demonstrate noninferiority (noninferiority bound, -15%), assuming that 30% of the patients in the C-ART arm would have <350 CD4 cells/mm3. Other end points were mortality, morbidity, cost of care, genotypic resistance, adherence, and toxicity. The percentage of patients with <350 CD4 cells/mm3 at 24 months was 5.6% (6 of 107) in the C-ART arm and 14.6% (46 of 315) in the 2/4-ART arm (lower bound of the 95% CI for the difference, -14%). Cost was 18% higher in the C-ART arm, and resistance to nonnucleoside reverse-transcriptase inhibitors (NNRTIs) was 20% higher in the 2/4-ART arm. Other end points were nonconclusive. Although 2/4-ART met the predetermined criteria for noninferiority, the percentage of patients with <350 CD4 cells/mm3 in the C-ART arm was lower than anticipated, which makes the clinical significance of this noninferiority uncertain. In addition, 2/4-ART led to an unacceptable additional risk of selecting for drug-resistant virus. This new argument against episodic ART strategies is also a caveat against any unplanned ART interruptions in Africa, where most patients receive NNRTIs.
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | ADULTS | TIME FACTORS | ADMINISTRATION AND DOSAGE | RISK ASSESSMENT | DRUG RESISTANCE | ANTIRETROVIRAL DRUGS | IMMUNITY, CELLULAR | GENETICS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Studies | Age Factors | Population Characteristics | Demographic Factors | Population | Population Dynamics | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation | Immunity | Immune System | Physiology | Biology
Document Number: 328597

Peer Reviewed

Title: Beneficial effects of offering prenatal HIV counselling and testing on developing a HIV Preventive attitude among couples. Abidjan, 2002-2005.
Author: Desgrees-Du-Lou A; Brou H; Djohan G; Becquet R; Ekouevi DK; Zanou B; Viho I; Allou G; Dabis F; Leroy V
Source: AIDS and Behavior. 2009 Apr;13(2):348-355.
Abstract: Prenatal HIV counselling and testing is mainly an entry-point to the prevention of mother-to-child transmission of HIV, but it may also play an important role in triggering the development of spousal communication about HIV and sexual risks and thus the adoption of a preventive attitude. In Abidjan, Coˆte d'Ivoire, we investigated couple communication on STIs and HIV, male partner HIV-testing and condom use at sex resumption after delivery among three groups of pregnant women who were offered prenatal counselling and HIV testing: HIVinfected women, uninfected women, and women who refused HIV-testing. The proportion of women who discussed STIs with their regular partner greatly increased after prenatal HIV counselling and testing in all three groups, irrespective of the women's serostatus and even in the case of test refusal. Spousal communication was related to more frequent male partner HIV-testing and condom use. Prenatal HIV counselling and testing proposal appears to be an efficient tool to sensitize women and their partner to safer sexual practices.
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | COUPLES | VOLUNTARY COUNSELING AND TESTING | HIV PREVENTION | ANTENATAL CARE | ATTITUDES | PARTNER COMMUNICATION | SPOUSAL SUPPORT | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Psychological Factors | Behavior | Interpersonal Relations | Microeconomic Factors | Risk Reduction Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections
Document Number: 340128

6.
Title: [An uncommon localization of pyoderma gangrenosum on the penis of an HIV infected patient in the Ivory Coast] L'atteinte du penis, une localisation rare du pyoderma gangrenosum: a propos d'un
Author: Ecra E; Ahogo KC; Sangare A; Kaloga M; Kassi K; Kouame K; Kacou DE; Gbery IP; Yoboue YP; Kanga JM
Source: Bulletin De La Societe De Pathologie Exotique. 2009 May;102(2):85-7.
Abstract: Pyoderma gangrenosum is an uncommon chronic ulcerative dermatosis with unknown aetiology and with a pathology which is still obscure. In 15-45% of cases, it is related to intestinal chronic inflammatory disease (MICI), to a systemic disease that it can sometimes reveals or to an immunodeficiency This disease starts whether with a pustule, a bubble or a nodule which leads during its evolvement to a superficial ulceration with clear edges. Its diagnosis is easy and is mainly clinical. It is a disease which is localized preferably in lower limbs. Treatment is mainly based on oral route corticotherapy. We report a case of gangrenosum pyoderma localized on the penis in a 43-year-old HIV infected patient. It is an uncommon localization, misleading and delicate. We have treated successfully this patient by oral corticotherapy combined with local antiseptic treatments for 6 months.
Language: French
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | MEN | PERSONS LIVING WITH HIV/AIDS | GENITAL EFFECTS, MALE | UROGENITAL EFFECTS | GASTROINTESTINAL EFFECTS | TREATMENT | DRUGS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342812

Peer Reviewed

Title: HIV type 1 drug resistance in adults receiving highly active antiretroviral therapy in Abidjan, Cote d'Ivoire.
Author: Hanson DL; Adje-Toure C; Talla-Nzussouo N; Eby P; Borget MY; Kouadio LY; Celestin BE; Tossou O; Eholie S; Kadio A; Chorba T; Nkengasong JN
Source: AIDS Research and Human Retroviruses. 2009 May;25(5):489-95.
Abstract: As antiretroviral therapy continues to scale-up in developing countries, there is concern that high levels of HIV drug resistance to antiretroviral drugs will occur. Here we describe rates of emergence of HIV-1 drug resistance and factors associated with their occurrence among adults who received antiretroviral therapy (ART) for >1 year through the Cote d'Ivoire national drug access program from 1998 to 2003. To detect genotypic drug resistance, we sequenced all 1- and 2-year specimens with detectable HIV RNA viral load. To assess factors associated with emerging drug resistance, we used log normal regression with interval censoring, including covariates in the model for self-reported drug adherence, CD4 cell count, and HIV viral load at therapy initiation, and observed changes in these measures, type of prescribed ART drugs, diagnoses of opportunistic illness, and demographic characteristics. An estimated 14.2% [95% confidence limits (CL) 11.7, 16.9] and 26.6% (95% CL 22.7, 30.8) of patients developed primary drug-resistant mutations within 1 year and 2 years after initiation of therapy, respectively. Factors associated with drug resistance included drug nonadherence, partial or lack of viral suppression, higher viral load or lower CD4 at initiation of therapy, and initiation of ART with what is now considered substandard dual combination therapy. Our results demonstrate the need to strengthen adherence and continuity in treatment programs in order to avoid interruption of ART drugs. Treatment programs should pay attention to indicators of emerging drug resistance: incomplete or lesser decreases in viral load or increases in CD4 cell counts following initiation of therapy, and the occurrence of AIDS opportunistic illnesses.
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | DRUG RESISTANCE | USER COMPLIANCE | LABORATORY PROCEDURES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses
Document Number: 341682

Peer Reviewed

Title: Implementing family-focused HIV care and treatment: the first 2 years' experience of the mother-to-child transmission-plus program in Abidjan, Cote d'Ivoire.
Author: Tonwe-Gold B; Ekouevi DK; Bosse CA; Toure S; Kone M; Becquet R; Leroy V; Toro P; Dabis F; El Sadr WM; Abrams EJ
Source: Tropical Medicine and International Health. 2009 Feb;14(2):204-12.
Abstract: OBJECTIVES: To describe a family-focused approach to HIV care and treatment and report on the first 2 years experience of implementing the mother-to-child transmission (MTCT)-plus program in Abidjan, Cote d'Ivoire. PROGRAM: The MTCT-plus initiative aims to enroll HIV-infected pregnant and postpartum women in comprehensive HIV care and treatment for themselves and their families. MAIN OUTCOMES: Between August 2003 and August 2005, 605 HIV-infected pregnant or postpartum women and 582 HIV-exposed infants enrolled. Of their 568 male partners reported alive, 52% were aware of their wife's HIV status and 30% were tested for HIV; 53% of these tested partners were found to be HIV-infected and 78% enrolled into the program. Overall only 10% of the women enrolled together with their infected partner. On the other hand, the program involved half of the seronegative men who came for voluntary counselling and testing (VCT) in the care of their families. Of 1624 children <15 years reported alive by their mothers (excluding the last newborn infants of the most recent pregnancy systematically screened for HIV), only 10.8% were brought in for HIV testing, of whom 12.3% were found to be HIV-infected. LESSONS LEARNED AND CHALLENGES: The family-focused model of HIV care pays attention to the needs of families and household members. The program was successful in enrolling HIV women, their partners and infants in continuous follow-up. However engaging partners and family members of newly enrolled women into care involves numerous challenges such as disclosure of HIV status by women to their partners and family members. Further efforts are required to understand barriers for families accessing HIV services as strategies to improve partner involvement and provide access to care for other children in the households are needed in this West African urban setting.
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | MOTHERS | COUPLES | POSTPARTUM WOMEN | MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | TREATMENT | VOLUNTARY COUNSELING AND TESTING | ANTIRETROVIRAL THERAPY | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Puerperium | Reproduction | Transmission | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | HIV | Program Evaluation | Programs | Organization and Administration
Document Number: 341027

Peer Reviewed

Title: Morbidity in HIV-1-Infected children treated or not treated with highly active antiretroviral therapy (HAART), Abidjan, Cote d'Ivoire, 2000-04.
Author: Walenda C; Kouakoussui A; Rouet F; Wemin L; Anaky MF; Msellati P
Source: Journal of Tropical Pediatrics. 2009 Jun;55(3):170-6.
Abstract: BACKGROUND: In the 2008 UNAIDS epidemic update, 33 million people worldwide were estimated infected with HIV, including 2.2 million children. In Cote d'Ivoire, 480,000 adults and 60,000 children were HIV-infected. Studies in developed countries have shown an improvement of children's morbidity under HAART treatment. OBJECTIVE: The objective of this study is to describe and compare morbidity in relation to evolution of the disease in HIV-1-infected children in Cote d'Ivoire, according to symptoms and the presence or absence of HAART treatment. METHODOLOGY: A total of 273 HIV-1-infected children from age 18 months to 18 years were included from October 2000 until December 2003. Follow-up was continued until 30 September 2004. The study population was divided in three groups. Group 1 included symptomatic children treated under HAART. Group 2 included asymptomatic children who did not need HAART treatment. Group 3 included children who met criteria to be treated at inclusion but were not treated. PRINCIPAL FINDINGS: The three most common diseases in Group 1 before treatment were bronchitis, diarrhoea and ear nose and throat (ENT) diseases. Under treatment, the three most common diseases in Group 1 were bronchitis, ENT diseases and diarrhoea. The three most occurring diseases in Group 2 were bronchitis, ENT diseases and skin infectious diseases. The three most occurring diseases in Group 3 were bronchitis, diarrhoea and ENT diseases. CONCLUSIONS: The incidence of diseases was significantly lower among asymptomatic children than among symptomatic untreated children (p < 0.0001). The morbidity found in symptomatic children who received treatment was similar to that encountered in asymptomatic children. The main reason for death in all of the groups was tuberculosis.
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | COHORT ANALYSIS | CHILDREN | PERSONS LIVING WITH HIV/AIDS | MORBIDITY | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | SIGNS AND SYMPTOMS | DISEASES | INCIDENCE | MORTALITY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | HIV | Measurement | Population Dynamics
Document Number: 341970

10.

Peer Reviewed

Title: Virologic and immunologic response to antiretroviral therapy and predictors of HIV type 1 drug resistance in children receiving treatment in Abidjan, Cote d'Ivoire.
Author: Adje-Toure C; Hanson DL; Talla-Nzussouo N; Borget MY; Kouadio LY; Tossou O; Fassinou P; Bissagnene E; Kadio A; Nolan ML; Nkengasong JN
Source: AIDS Research and Human Retroviruses. 2008 Jul;24(7):911-7.
Abstract: We describe changes in HIV-1 viral load, CD4+ T cell percentage, and incidence of drug resistance and factors associated with drug resistance for 134 children receiving antiretroviral therapy (ART) for approximately 1 year in Abidjan. Between August 1998 and September 2003, ART was initiated for 395 HIV-infected children ages 0-15 years in the Cote d'Ivoire national drug access initiative. All 1-year samples with detectable HIV RNA >1000 copies/ml were tested for HIV-1 drug resistance and changes in viral load and CD4+ T cell counts were also determined. At treatment initiation, 80% of children had CD4+ T cell percentages <15% and a median viral RNA load of 5.6 log copies/ml. The median age at treatment initiation was 7 years with only 25% of patients less than 4 years of age. Of the 134 children receiving therapy, 72 (54%) had undetectable viral load. The estimated 1-year viral load decline was 1.9 log10 copies/ml and the CD4+ T cell percentage increase was 10.9%. The estimated 1-year cumulative probability for developing any class of drug resistance was 0.44 (95% CI, 0.35, 0.53). In a multivariate analysis, the magnitude of virologic response to therapy was inversely associated with development of drug resistance. Children with less CD4+ T cell rise from baseline values and the use of dual therapy were also associated with the development of drug resistance. Guidelines are needed for the treatment of pediatric HIV infection in Africa in order to minimize the occurrence of drug resistance and enhance better virologic, immunologic, and clinical outcomes.
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | GENETIC TECHNIQUES | MULTIVARIATE ANALYSIS | PERSONS LIVING WITH HIV/AIDS | CHILDREN | TIME FACTORS | HIV INFECTIONS | DRUG RESISTANCE | ANTIRETROVIRAL THERAPY | IMMUNITY, CELLULAR | CHROMOSOME ABNORMALITIES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Data Analysis | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Population Dynamics | Treatment | HIV | Immunity | Immune System | Physiology | Biology | Neonatal Diseases and Abnormalities
Document Number: 328637

11.

Title: Early mixed feeding and breastfeeding beyond 6 months increase the risk of postnatal HIV transmission: ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire.
Author: Becquet R; Ekouevi DK; Menan H; Amani-Bosse C; Bequet L
Source: Preventive Medicine. 2008 Jul;47(1):27-33.
Abstract: The objective was to evaluate the risk of postnatal HIV transmission among women in Abidjan, Cote d'Ivoire offered alternatives to prolonged breastfeeding, and to assess the impact of the breastfeeding pattern and duration on this risk. In 2001-2003, HIV-infected pregnant women received peri-partum antiretroviral prophylaxis and were counselled antenatally regarding infant feeding options: formula feeding or exclusive breastfeeding with early cessation from 4 months of age. The primary outcome was HIV postnatal transmission by 18 months of age, defined by a positive HIV test after a negative test greater than or equal to 30 days. The effect of the pattern (mixed feeding, defined as breastmilk plus food-based fluid, solid food or non-human milk) and duration (less vs. more than 6 months) of breastfeeding on postnatal transmission was assessed. Of 622 live-born infants who were HIV uninfected at or after 30 days, 15 were infected postnatally, 13/324 among breastfed, and 2/ 298 among formula-fed infants. The 18-month probability of remaining free from HIV infection was 0.95 [95% CI, 0.92-0.97] and 0.99 [95% CI, 0.97-1.00] in the breastfeeding and formula-feeding groups respectively (p less than 0.001). In adjusted analysis, breastfeeding for more than 6 months and mixed feeding during the first month of life were independently associated with a 7.5 (AOR 95% CI, 2.0-28.2, p=0.003)- and a 6.3 (95% CI, 1.1-36.4, p=0.04)-fold increase of postnatal transmission among breastfed children. Mixed feeding during the first month of life and breastfeeding beyond 6 months are strong determinants of HIV transmission and should be avoided when replacement feeding after breastfeeding cessation can be safely and sustainably provided. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | MOTHERS | INFANT | HIV TRANSMISSION | MOTHER-TO-CHILD TRANSMISSION | BREASTFEEDING | INFANT NUTRITION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Transmission | Infections | Nutrition | Health
Document Number: 327083

12.

Title: Influence of the asexual parasite biomass on in vitro susceptibility of Plasmodium falciparum to antimalarial drugs in Abidjan.
Author: Bla KB; Yavo W; Ouattara L; Basco L; Djaman AJ
Source: African Journal of Biotechnology. 2008 Apr;7(8):936-940.
Abstract: The in vitro activities of artemisinin, dihydroartemisinin (the biologically active metabolite of artemisinin derivatives), chloroquine and pyronaridine were assessed in 32 isolates of Plasmodium falciparum from Abobo in the northern of Abidjan district (Cote d'Ivoire) using a test based on the standard microtechnique recommended by the World Health Organization (WHO). The parasites densities were ranged between 8,000 and 540,000 rings/microl of blood. The geometric means 50% inhibitory concentration (GMIC50) values for chloroquine, pyronaridine and artemisinin were 145.5 nM (95% confidence interval (CI) = 65-226 nM), 17.69 nM (95% CI = 9.1-26.3 nM) and 5.72 nM (95% CI = 2.3-9.1 nM), respectively. Dihydroartemisinin was the most potent drug against chloroquine-sensitive and chloroquine-resistant isolates with a geometric mean of 2.72 nM. There was no correlation between the parasite densities and the responses to chloroquine (r/2 = 0.01, p less than 0.5), pyronaridine (r/2 = 0.13, p less than 0.05), artemisinin (r/2 = 0.13, p less than 0.05) and dihydroartemisinin (r/2 = 0.07, p less than 0.1). (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | IN VITRO | LABORATORY PROCEDURES | MALARIA PREVENTION | ANTIMALARIAL DRUGS | PARASITES | CONTRACEPTIVE USE-EFFECTIVENESS | MONITORING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Malaria | Parasitic Diseases | Diseases | Biology | Contraceptive Effectiveness | Contraception | Family Planning | Evaluation
Document Number: 326233

13.

Peer Reviewed

Title: Sexual prevention of HIV within the couple after prenatal HIV-testing in West Africa.
Author: Brou H; Djohan G; Becquet R; Allou G
Source: AIDS Care. 2008 Apr;20(4):413-418.
Abstract: The resumption of sexual activity after delivery is a key moment in the management of the risk of sexual HIV transmission within the couple for women who have been prenatally tested for HIV. In this study, we have investigated consistent condom use during the resumption of sexual activity and its evolution over time among women tested for HIV infection during pregnancy. We tested for HIV during pregnancy 546 HIV-infected and 393 HIV-negative women within the Ditrame Plus ANRS project in Abidjan; these women were followed-up for two years after delivery. Most HIV-negative women (96.7%) disclosed their HIV-test result to their partners, where as only 45.6% of HIV-infected women did so (p less than 0.001). Partners of HIV-infected women were more likely to be tested for HIV before resuming sexual activity than partners of HIV-negative women (11.7% vs. 7.4%, p = 0.054). Less than one third of both HIV-infected and HIV-negative women reported having systematically used condoms during the resumption of sexual activity. The proportions of HIV-infected and HIV-negative women having consistently used condoms were respectively 26.2% and 19.8% (p = 0.193) at 3 months post-partum, 12.1% and 15.9% (p = 0.139) at 12 months post-partum, and 8.4% and 10.6% (p = 0.302) at 18 months post-partum. In our study, although women had been prenatally tested for HIV and properly counselled on the sexual risk of HIV transmission, male partners were not tested for HIV before the resumption of sexual activity after delivery, very few couples were using condoms systematically and condom use was decreasing over time. (author's)
Language: English
Keywords:
AFRICA, WESTERN | COTE D'IVOIRE | RESEARCH REPORT | FOLLOW-UP STUDIES | PERSONS LIVING WITH HIV/AIDS | POSTPARTUM WOMEN | COUPLES | HIV PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | VOLUNTARY COUNSELING AND TESTING | CONDOM USE | SEX BEHAVIOR | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Puerperium | Reproduction | Family Characteristics | Family and Household | Sociocultural Factors | Disease Transmission Control | Prevention and Control | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Reduction Behavior | Behavior
Document Number: 326546

14.

Peer Reviewed

Title: Maternal 12-month response to antiretroviral therapy following prevention of mother-to-child transmission of HIV type 1, Ivory Coast, 2003 -- 2006.
Author: Coffie PA; Ekouevi DK; Chaix ML; Tonwe-Gold B; Clarisse AB
Source: Clinical Infectious Diseases. 2008 Feb 15;46(4):611-621.
Abstract: Our aim was to study the response to antiretroviral treatment among women exposed to singledose nevirapine (NVP) and/or short-course zidovudine (ZDV; with or without lamivudine [3TC]) for the prevention of mother-to-child transmission of human immunodeficiency virus (HIV) infection. All HIV type 1-infected women who initiated antiretroviral treatment with stavudine or ZDV, 3TC, and NVP or efavirenz were eligible for the MTCT-Plus program in Abidjan, Ivory Coast. Exposed women had received either single-dose NVP alone or short-course ZDV (with or without 3TC) plus single-dose NVP during previous pregnancy. Genotypic resistance testing was performed at week 4 after delivery. Virologic failure was defined as a plasma HIV RNA level 1500 copies/mL 12 months after initiation of antiretroviral treatment. Among 247 women who received antiretroviral treatment, 109 (44%) were unexposed; 81 had received short-course ZDV with 3TC, as well as single-dose NVP; 5 had received short-course ZDV plus 3TC; 50 had received short-course ZDV plus single-dose NVP; and 2 had received single-dose NVP alone. No ZDV mutation was detected in the 115 women whose specimens were available for genotypic testing; 11 (15.1%) of 73 women with 3TC exposure who were tested after delivery had 3TC resistance mutations. Three (4.3%) of 69 women exposed to short-course ZDV and 3TC plus single-dose NVP and 16 (38.1%) of 42 women exposed to short-course ZDV plus single-dose NVP had NVP resistance mutations. Antiretroviral treatment was initiated a median of 21 months after the intervention to prevent mother-to-child HIV transmission (median CD4+ T lymphocyte count, 188 cells/mm3). Month 12 virologic failure was identified in 42 (19.2%) of 219 women for whom data were available, and multivariate analysis revealed that it was associated with poor adherence to treatment (adjusted odds ratio [aOR], 12.7; 95% confidence interval [CI], 3.0-53.9), postpartum 3TC resistance mutations (aOR, 6.9; 95% CI, 1.1-42.9), and a baseline CD4+ T lymphocyte count!200 cells/mm3 (aOR, 0.3; 95% CI, 0.2-0.8). NVP resistance was not associated with virological failure (aOR, 1.8; 95% CI, 0.5-6.5). Our study found that poor adherence and 3TC resistance acquired after the intervention to prevent mother-to-child transmission of HIV infection were associated with virologic failure in women who initiated antiretroviral treatment. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | MOTHERS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | USER COMPLIANCE | IMMUNOLOGICAL EFFECTS | IMMUNOLOGIC FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Studies | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | HIV | Disease Transmission Control | Prevention and Control | Behavior | Immunity | Immune System | Physiology | Biology
Document Number: 323779

15.

16.

Peer Reviewed

Title: CD4 cell response before and after HAART initiation according to viral load and growth indicators in HIV-1-infected children in Abidjan, Cote d'Ivoire.
Author: De Beaudrap P; Rouet F; Fassinou P; Kouakoussui A; Mercier S
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Sep 1;49(1):70-6.
Abstract: OBJECTIVE: To analyze the determinants of CD4 change in children during 3 periods: before highly active antiretroviral therapy (HAART), during the first year after HAART initiation, and past 1 year after HAART initiation. METHODS: One hundred seventy-seven children enrolled in a prospective cohort in Abidjan received HAART during a mean follow-up of 30 months. A linear mixed-effects model was used for the first period, a mixed-effects piecewise model for the second period, and an asymptotic mixed-effects model for long-term CD4 dynamics. RESULTS: Before HAART initiation, CD4 percentage decreased along time [beta = -0.59 (-0.92 to -0.26)] was positively associated with body mass index for age [beta = 0.47 (0.22 to 0.72)] and negatively associated with viral load [beta = -1.01 (-1.90 to -0.13)]. During the first year of treatment, the CD4 decrease reverted to a steep increase that was negatively associated with age at HAART initiation [beta = -0.24 (-0.4 to -0.07)] and with the mean viral load underHAART [beta = -1.51 (-2.21 to -0.81)]. The long-term CD4 percentage was also negatively associated with the mean viral load under HAART [beta = -4.97 (-6.22 to -3.72)] and age at HAART initiation [beta = -0.82 (-1.12 to -0.51)]. CONCLUSIONS: Before HAART initiation, the CD4 cell percentage was associated with growth indicators whereas, after HAART, an early increase and a long-term plateau were negatively associated with the viral load and age at HAART initiation.
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | TREATMENT | GROWTH | BODY WEIGHT | CHILD | AGE FACTORS | INFANT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Child Development | Biology | Physiology | Youth | Population Characteristics | Demographic Factors | Population
Document Number: 328261

17.

Peer Reviewed

Title: Quality of antenatal and delivery care before and after the implementation of a prevention of mother-to-child HIV transmission programme in Cote d’Ivoire.
Author: Delvaux T; Konan JP; Ake-Tano O; Gohou-Kouassi V; Bosso PE
Source: Tropical Medicine and International Health. 2008 Aug;13(8):970-979.
Abstract: The objective of this study was to assess whether implementation of a prevention of mother-to-child HIV transmission (PMTCT) programme in Cote d?Ivoire improved the quality of antenatal and delivery care services. Quality of antenatal and delivery care services was assessed in five urban health facilities before (2002-2003) and after (2005) the implementation of a PMTCT programme through review of facility data; observation of antenatal consultations (n = 606 before; n = 591 after) and deliveries (n = 229 before; n = 231 after) and exit interviews of women; and interviews of health facility staff. HIV testing was never proposed at baseline and was proposed to 63% of women at the first ANC visit after PMTCT implementation. The overall testing rate was 42% and 83% of tested HIVinfected pregnant women received nevirapine. In addition, inter-personal communication and confidentiality significantly improved in all health facilities. In the maternity ward, quality of obstetrical care at admission, delivery and post-partum care globally improved in all facilities after the implementation of the programme although some indicators remained poor, such as filling in the partograph directly during labour. Episiotomy rates among primiparous women dropped from 64% to 25% (P < 0.001) after PMTCT implementation. Global scores for quality of antenatal and delivery care significantly improved in all facilities after the implementation of the programme. Introducing comprehensive PMTCT services can improve the quality of antenatal and delivery care in general. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | PRE-POST TESTS | PROGRAM EVALUATION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION | ANTENATAL CARE | MATERNAL HEALTH SERVICES | QUALITY OF HEALTH CARE | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Programs | Organization and Administration | Disease Transmission Control | Prevention and Control | Diseases | HIV Infections | Viral Diseases | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Health Services Evaluation
Document Number: 327476

18.

Peer Reviewed

Title: Antiretroviral therapy in pregnant women with advanced HIV disease and pregnancy outcomes in Abidjan, Cote d’Ivoire.
Author: Ekouevi DK; Coffie PA; Becquet R; Tonwe-Gold B; Horo A
Source: AIDS. 2008 Sep 12;22(14):1815-1820.
Abstract: Pregnancy outcomes in women receiving highly active antiretroviral treatment (HAART) in Africa are not well described. HIV-1-infected pregnant women in the ANRS Ditrame Plus and the MTCTPlus projects were included. Between March 2001 and July 2003, when HAART was not yet available, women eligible for HAART received a short-course antiretroviral regimen, zidovudine (ZDV) or (ZDV + lamivudine) and single dose of nevirapine for preventing mother-to-child transmission (PMTCT group). Between August 2003 and August 2007, eligible women for HAART received it (HAART group). The frequencies of low birth weight (LBW) (<2500 g), stillbirth and infant mortality are reported. Risk factors associated with LBW were investigated using a logistic regression model. Of the 326 HIV-infected pregnant women, 175 women received short-course antiretroviral (median CD4 cell count 177 cells/ul) and 151 received HAART (median CD4 cell count 182 cells/ul). At 12 months, three paediatric infections (2.3%) occurred in the HAART group vs. 25 (16.1%) in the PMTCT group (P<0.001). The rate of LBW was 22.3% in the HAART group and 12.4% in the PMTCT group (P=0.02). In multivariable analysis (n=309), after adjustment on maternal CD4 cell count, WHO stage, age and maternal BMI, HAART initiated before pregnancy [adjusted odds ratio (OR) 2.88, 95% confidence interval (CI) 1.10-7.51] and during pregnancy (adjusted OR 2.12, 95% CI 1.15-4.65) and maternal BMI at delivery (adjusted OR 2.43, 95% CI 1.20-4.91) were associated with LBW. HAART in pregnant African women with advanced HIV disease substantially reduced mother-to-child transmission, but was associated with LBW. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | LOW BIRTH WEIGHT | FETAL DEATH | INFANT MORTALITY | RISK FACTORS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | HIV | Birth Weight | Body Weight | Physiology | Biology | Mortality | Population Dynamics | Disease Transmission Control | Prevention and Control
Document Number: 328146

19.

Peer Reviewed

Title: A non-randomized vaccine effectiveness trial of accelerated infant hepatitis B immunization schedules with a first dose at birth or age 6 weeks in Cote d'Ivoire.
Author: Ekra D; Herbinger KH; Konate S; Leblond A; Fretz C
Source: Vaccine. 2008 May;26(22):2753-2761.
Abstract: Most African countries do not initiate hepatitis B vaccination at birth. We conducted a non-randomized controlled trial comparing hepatitis B vaccination given at age 0, 6, and 14 weeks versus the current Cote d'Ivoire schedule of 6, 10, and 14 weeks. Pregnant women were enrolled at four health centers in Abidjan. At age 9 months, 0.5% of infants in both the birth and 6-week cohorts were positive for HBsAg and all were born to HBeAg-positive women. Among infants of HBeAg-positive mothers, 9 of 24 (37.5%) in the birth cohort and 10 of 17 (58.8%) in the 6-week cohort were HBsAg positive (adjusted OR, 2.7; 95% CI: 0.7-11.0). While both vaccine schedules prevented most cases of infant HBV transmission, both also had high failure rates among infants of HBeAg-positive mothers. African infants may benefit from a birth dose but additional studies are needed to verify this hypothesis. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | CHILD | IMMUNIZATION SCHEDULE | HEPATITIS | VACCINES | AGE FACTORS | PREVENTION AND CONTROL | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Youth | Population Characteristics | Demographic Factors | Population | Immunization | Primary Health Care | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Medical Procedures | Medicine
Document Number: 326739

20.

Peer Reviewed

Title: 18-month occurrence of severe events among early diagnosed HIV-infected children before antiretroviral therapy in Abidjan, Cote d'Ivoire: A cohort study.
Author: Harambat J; Fassinou P; Becquet R; Toure P; Rouet F
Source: BMC Public Health. 2008 May 20;:[20] p.
Abstract: The objective was to assess the 18-month field effectiveness on severe events of a pediatric package combining early HIV-diagnosis and targeted cotrimoxazole prophylaxis in HIV-infected children from age six-week before the antiretroviral era, in Abidjan, Cote d'Ivoire. Data from two consecutive prevention of HIV mother-to-child transmission programs were compared: the ANRS 1201/1202 Ditrame-Plus cohort (2001-2005) and the pooled data of the ANRS 049a Ditrame randomized trial and its following open-labeled cohort (1995-2000), used as a reference group. HIV-infected pregnant women greater than or equal to 32-36 weeks of gestation were offered a short-course peripartum antiretroviral prophylaxis (ZDV in Ditrame, and ZDV plus or minus 3TC+single-dose (sd) NVP in Ditrame-Plus). Neonatal prophylaxis was provided in Ditrame-Plus only: 7-day ZDV and sdNVP 48-72h after birth. A 6-week pediatric HIV-RNA diagnosis was provided on-line in the Ditrame-Plus while it was only oriented on clinical symptoms in Ditrame. Six-week HIV-infected children received a daily cotrimoxazole prophylaxis in Ditrame-Plus while no prophylaxis was provided in Ditrame. The determinants of severe events (death or hospitalization greater than 1 day) were assessed in a Cox regression model. Between 1995 and 2003, 98 out of the 1121 live-births were diagnosed as HIV-infected in peri-partum: 45 from Ditrame-Plus and 53 from Ditrame. The 18-month Kaplan-Meier cumulative probability of presenting a severe event was 66% in Ditrame-Plus (95% confidence interval [95%CI]: 50%-81%) and 77% in Ditrame (95%CI: 65%-89%), Log Rank test: p=0.47. After adjustment on maternal WHO clinical stage, maternal death, 6-week pediatric viral load, birth-weight, and breastfeeding exposure, the 18-month risk of severe event was lower in Ditrame-Plus than in Ditrame (adjusted Hazard Ratio (aHR): 0.55, 95%CI: 0.3-1.1), although the difference was not statistically significant; p=0.07). Maternal death was the only variable determinant of the occurrence of severe events in children (aHR: 3.73; CI: 2.2-11.2; p=0.01). Early cotrimoxazole from 6 weeks of age in HIV-infected infants seemed to reduce probability of severe events but the study lacked statistical power to prove this. Even with systematic cotrimoxazole prophylaxis, infant morbidity and mortality remained high pointing towards a need for early pediatric HIV-diagnosis and antiretroviral treatment in Africa. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | COHORT ANALYSIS | CHILD | PERSONS LIVING WITH HIV/AIDS | EXAMINATIONS AND DIAGNOSES | HIV TESTING | ANTIRETROVIRAL THERAPY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | HIV
Document Number: 326948

21.

Peer Reviewed

Title: Sexual abstinence behavior among never-married youths in a generalized HIV epidemic country: evidence from the 2005 Cote d'Ivoire AIDS indicator survey.
Author: Koffi AK; Kawahara K
Source: BMC Public Health. 2008 Dec 16;8(408):15 p.
Abstract: The authors explored sexual abstinence among never-married individuals aged 15 to 24 in Cote d'Ivoire and assessed factors that predict sexual abstinence. They obtained data from the nationally representative and population-based 2005 Cote d'Ivoire AIDS Indicator Survey, conducted from September 2004 to October 2005. The sample included 3,041 never-married people aged 15 to 24. Of these, 990 reported never having sexual intercourse (primary abstinence) and 137 reported sexual experience but not in the 12 months prior to the survey (secondary abstinence). In all, 1,127 youths reported sexual abstinence practice. Of the 3,041 never-married youths, 54.4% were male and 45.6% were female. About 33.0%, 6.7%, and 37.1% of them were practicing primary, secondary, and sexual abstinence behavior, respectively. Females of higher education level were about 11 times as likely as those of no education to practice either primary or secondary abstinence. Males who were animists, had no religion, or were practicing religions other than Christianity or Muslim were significantly less likely than other male youths to practice sexual abstinence. Living in the north-west region of the country significantly decreased the odds of sexual abstinence among female youths. Similarly, female youths living in rural areas were 0.42 times as likely as those in the urban zones to practice sexual abstinence.
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | RURAL AREAS | ADOLESCENTS | YOUTH | ABSTINENCE | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV PREVENTION | AIDS PREVENTION | ADOLESCENT PREGNANCY | RELIGION | INTERVENTIONS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Geographic Factors | Population | Age Factors | Population Characteristics | Demographic Factors | Family Planning, Behavioral Methods | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases | AIDS | Reproductive Behavior | Fertility | Population Dynamics | Sociocultural Factors | Programs | Organization and Administration
Document Number: 329526

23.

Peer Reviewed

Title: 18-month effectiveness of short-course antiretroviral regimens combined with alternatives to breastfeeding to prevent HIV mother-to-child transmission.
Author: Leroy V; Ekouevi DK; Becquet R; Viho I; Dequae-Merchadou L
Source: PLoS One. 2008 Feb;3(2):e1645.
Abstract: We assessed the 18-month effectiveness of short-course (sc) antiretroviral peripartum regimens combined with alternatives to prolonged breastfeeding to prevent mother-to-child transmission (MTCT) of HIV-1 in Abidjan, Cote d'Ivoire. HIV-1 infected pregnant women received from greater than or less than 32-36 weeks of gestation scZidovudine (ZDV)+/-Lamivudine (3TC)+single-dose Nevirapine (sdNVP) at delivery within the ANRS 1201/1202 DITRAME-Plus cohort (2001-2003). Neonates received a sdNVP+7-day ZDV prophylaxis. Two infant-feeding interventions were systematically offered free of charge: formula-feeding or exclusive shortened breastfeeding with early cessation from four months. The reference group was the ANRS 049a DITRAME cohort (1994-2000) exposed to scZDV from 36 weeks, then to prolonged breastfeeding. Pediatric HIV infection was defined by a positive plasma HIV-1 RNA at any age, or if aged $18 months, a positive HIV-1 serology. Turnbull estimates of cumulative transmission risks (CTR) and effectiveness (HIV-free survival) were compared by exposure group using a Cox model. Among 926 live-born children enrolled, 107 (11.6%) were HIV-infected at 18 months. CTRs were 22.3% (95% confidence interval[CI]:16-30%) in the 238 ZDV long-term breastfed reference group, 15.9% (CI:10-27%) in the 169 ZDV+sdNVP shortened breastfed group; 9.4% (CI:6-14%) in the 195 ZDV+sdNVP formula-fed group; 6.8% (CI:4-11%) in the 198 ZDV+3TC+sdNVP shortened breastfed group, and 5.6% (CI:2-10%) in the 126 ZDV+3TC+sdNVP formula-fed group. Each combination had a significantly higher effectiveness than the ZDV long-term breastfed group except for ZDV+sdNVP shortened breastfed children, ranging from 51% (CI:20-70%) for ZDV+sdNVP formula fed children to 63% (CI:40-80%) for ZDV+3TC+NVPsd shortened breastfed children, after adjustment for maternal eligibility for antiretroviral therapy (ART), home delivery and low birth-weight. Substantial MTCT risk reductions are reachable in Africa, even in short-term breastfed children. The two sc antiretroviral combinations associated to any of the two infant feeding interventions, formula-feeding and shortened breastfeeding, reduce significantly MTCT with long-term benefit until age 18 months and without increasing mortality. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | MOTHERS | PERSONS LIVING WITH HIV/AIDS | INFANT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | ANTIRETROVIRAL THERAPY | ADMINISTRATION AND DOSAGE | BREASTFEEDING, EXCLUSIVE | BOTTLE FEEDING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Disease Transmission Control | Prevention and Control | HIV | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Breastfeeding | Infant Nutrition | Nutrition
Document Number: 324887

24.

Peer Reviewed

Title: Anthropometric and immunological success of antiretroviral therapy and prediction of virological success in west African adults.
Author: Messou E; Gabillard D; Moh R; Inwoley A; Sorho S
Source: Bulletin of the World Health Organization. 2008 Jun;86(6):435-442.
Abstract: The 6 month assessment of the response to antiretroviral therapy (ART) is a critical step. In sub-Saharan Africa, few people have access to plasma viral-load measurement. We assessed the gain or loss in body mass index (BMI), alone or in combination with the gain or loss in CD4+ T-cell count (CD4), as a tool for predicting the response to ART. In a cohort of 622 adults in Abidjan, Cote d'Ivoire, we calculated the sensitivity, specificity and predictive values of BMI and CD4 for treatment success defined as viral-load undetectability (less than 300 copies/ml) as gold standard. After 6 months of ART, the median change in BMI was an increase of 1.0 kg/m/2 (interquartile range, IQR: 0.0-2.1), the median change in CD4 an increase of 148/microl (IQR: 54-230) and 84% of patients reached viral-load undetectability. The distribution of change in BMI was similar among patients who reached undetectability and those who did not (increases of 1.06 kg/m/2 versus 0.99 kg/m/2, P = 0.51). With larger changes in BMI, the specificity for treatment success increased but its sensitivity decreased and its positive predictive value was stable around 85%. All results remained similar when combining changes in BMI with those in CD4 and when stratifying by groups of baseline BMI or CD4. In settings where viral-load measurement is not available, a high BMI gain does not reflect virological success, even when combined with a high CD4 gain. In our population, most patients with detectable viral-load had probably adhered to the drug regimen sufficiently to reach significant gains in body mass and CD4 count but had adhered insufficiently to reach viral suppression. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | PROSPECTIVE STUDIES | COHORT ANALYSIS | ADULTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | BODY WEIGHT | IMMUNOGLOBULIN ALTERATIONS | MEASUREMENT | USER COMPLIANCE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | HIV | Physiology | Biology | Hematological Effects | Hemic System | Behavior
Document Number: 327000

25.

Peer Reviewed

Title: HIV-1 DNA in peripheral blood mononuclear cells is strongly associated with HIV-1 disease progression in recently infected West African adults.
Author: Minga AK; Anglaret X; Toni TD; Chaix ML; Dohoun L
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Jul;48(3):350-354.
Abstract: The objective of this study was to analyze the association between the HIV-1 DNA level in peripheral blood mononuclear cells (PBMCs) and disease progression in recently infected West African adults. HIV-1 DNA levels were measured in the PBMCs of 200 adults in the French National Agency for Research on AIDS and viral Hepatitis (ANRS) 1220 cohort who had recently been infected with HIV-1. The association between baseline HIV-1 DNA levels and disease progression was analyzed using multivariate Cox regression. Disease progression was defined as the occurrence of any of the following outcomes: death, first World Health Organization stage 3-4 event, or CD4 count <200/mm3. About 200 participants were followed for a median of 30 months. At baseline, the median time from HIV-1 seroconversion was 9 months, median CD4+ T-cell count was 471/mm3, median HIV-1 DNA level was 3.0 log10 copies/106 PBMCs, and median plasma HIV-1 RNA level was 4.6 log10 copies/mL. The 5-year probability of remaining free of any outcome was 0.74 [95% confidence interval (CI): 0.61 to 0.83] and 0.36 (95% CI: 0.23 to 0.49) in patients with baseline HIV-1 DNA < or = 3.0 and >3.0 log10 copies/106 PBMCs, respectively (P < 0.001). The adjusted hazard ratio of disease progression was 2.17 in patients with HIV-1 DNA >3.0 log10 copies/106 PBMCs compared with other patients (95% CI: 1.24 to 3.80, P = 0.007). The only other factor associated with progression was follow-up CD4 count (hazard ratio = 1.23 per 100 cells/mm3 decrease; 95% CI: 1.07 to 1.41, P = 0.003). PBMC HIV-1 DNA level was strongly associated with HIV-1 disease progression, even after adjusting for HIV-1 RNA and CD4+ T-cell count. Further studies should assess whether patients with high HIV-1 DNA levels should start antiretroviral therapy earlier than other patients. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | CLINICAL RESEARCH | ADULTS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | MEASUREMENT | ANTIRETROVIRAL THERAPY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | HIV
Document Number: 327495

26.

Peer Reviewed

Title: Frequent occurrence of chronic hepatitis B virus infection among West African HIV type-1-infected children.
Author: Rouet F; Chaix ML; Inwoley A; Anaky MF; Fassinou P
Source: Clinical Infectious Diseases. 2008 Feb;46(3):361-366.
Abstract: The aim of this study, conducted in Ivory Coast, was to evaluate the prevalence and evolution of viral hepatitis in children coinfected with human immunodeficiency virus type 1 (HIV-1). Hepatitis B virus (HBV) and hepatitis C virus (HCV) markers were retrospectively and longitudinally assessed among 280 HIV-1-infected children enrolled in the Agence Nationale de Recherches sur le SIDA et les Hepatites Virales B et C 1244/1278 cohort. Among these, 173 (61.8%) received highly active antiretroviral therapy (HAART), including lamivudine (3TC) for 122 children. Detection of the hepatitis B s antigen (HBsAg) was performed on specimens collected at inclusion and 6 months later. If results of both tests were positive, hepatitis B e antigen (HBeAg)/hepatitis B e antibody (HBeAb) and HBV DNA levels were measured at inclusion and during follow-up. A fourth-generation HCV enzyme immunoassay was used for HCV screening at inclusion. In our pediatric cohort, no patients were infected with HCV, but the prevalenceof HBsAg at inclusion was 12.1% (34 of 280; 95% confidence interval [CI], 8.6-16.6). Among the HBV-HIV-1-coinfected children, a high rate of positive HBeAg chronic hepatitis B (CHB) was noted at inclusion (82.4% [28 of 34]; 95% CI, 65.5%-93.2%) and after a median follow-up of 18 months (78.3%; 95% CI, 45.5%-92.7%), with no significant difference between children treated with HAART (with or without 3TC) and untreated ones. These children showed high HBV DNA levels (usually 18.0 log10 copies/mL) and viral population consisting of nearly exclusively wild-type HBeAg-positive HBV strains, strongly suggesting that most of them were in the initial immunotolerant phase of chronic hepatitis B. In sub-Saharan Africa, children with chronic hepatitis B and who are treated with 3TC-based HAART are at risk of developing 3TC resistance. Further studies are required to guide the management of HBV-HIV-1-coinfected children. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | RETROSPECTIVE STUDIES | LONGITUDINAL STUDIES | PERSONS LIVING WITH HIV/AIDS | CHILDREN | ANTIRETROVIRAL THERAPY | CHRONIC DISEASES | HEPATITIS | ANTIGENS | ANTIBODIES | LABORATORY PROCEDURES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 323513

28.

Peer Reviewed

Title: Rapid scaling-up of antiretroviral therapy in 10,000 adults in Cote d'Ivoire: 2-year outcomes and determinants.
Author: Toure S; Kouadio B; Seyler C; Traore M; Dakoury-Dogbo N
Source: AIDS. 2008 Apr 23;22(7):873-882.
Abstract: The objective was to assess the rates and determinants of mortality, loss to follow-up and immunological failure in a nongovernmental organization-implemented program of access to antiretroviral treatment in Cote d'Ivoire. In each new treatment center, professionals were trained in HIV care, and a computerized data system was implemented. Individual patient and program level determinants of survival, loss to follow-up and immunological failure were assessed by multivariate analysis. Between May 2004 and February 2007, 10 211 patients started antiretroviral treatment in 19 clinics (median preantiretroviral treatment CD4 cell count, 123 cells/ml; initial regimen zidovudine-lamivudine-efavirenz, 20%; stavudine-lamivudine-efavirenz, 22%; stavudine-lamivudine-nevirapine, 52%). At 18 months on antiretroviral treatment, the median gain in CD4 cell count was +202 cells/microl, the probability of death was 0.15 and the probability of being loss to follow-up was 0.21. In addition to the commonly reported determinants of impaired outcomes (low CD4 cell count, low BMI, low hemoglobin, advanced clinical stage, old age and poor adherence), two factors were also shown to independently jeopardize prognosis: male sex (men vs. women: hazard ratio = 1.52 for death, 1.27 for loss to follow-up, 1.31 for immunological failure); and attending a recently opened clinic (inexperienced vs. experienced centers: hazard ratio = 1.40 for death, 1.58 for loss to follow-up). None of the three outcomes was associated with the drug regimen. In this rapidly scaling-up program, survival and immune reconstitution were good; women and patients followed up in centers with longer experience had better outcomes; outcomes were similar in zidovudine/stavudine-based regimens and in efavirenz/nevirapine-based regimens. Decreasing the rate of loss to follow-up should now be the top priority in antiretroviral treatment rollout. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | ADULTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | PROGRAM EFFECTIVENESS | DEATH RATE | MORTALITY DETERMINANTS | IMMUNOLOGICAL EFFECTS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | HIV | Program Evaluation | Programs | Organization and Administration | Mortality | Population Dynamics | Immunity | Immune System | Physiology | Biology
Document Number: 326380

29.

Title: Ureaplasma urealyticum or Mycoplasma hominis. Infections and semen quality of infertile men in Abidjan.
Author: Zinzendorf NY; Kouassi-Agbessi BT; Lathro JS; Don C; Kouadio L
Source: Journal of Reproduction and Contraception. 2008 Jun;19(2):65-72.
Abstract: The objective of this study was to determine the prevalence of U. urealyticum and M. hominis in semen samples collected from men admitted in clinic for infertility, and to compare the quality of these semen samples. A total of 1058 semen samples collected were investigated. Sperm semiological assays were performed according to the guidelines of the World Health Organisation (WHO). Semen were examined by Mycoplasma IST for the detection of mycoplasma. Semen culture on agar media was used to detect other microorganisms. Chlamydia was detected using direct fluorescent assay (DFA) of Clamydia Trachomatis. Among 1058 semen samples, microorganisms were detected in 638 (60.3%). The infected sperms consisted of mycoplasma alone in 507 cases (47.9%), mycoplasma and other microorganisms in 98 (9.3%), giving in all 605 (57.2%) samples infected with mycoplasma. The last 33 (3.1%) consisted of other microorganisms alone. The frequency of U.urealyticum, M. hominis and mixed genital infections detected in semen samples of infertile men were 39%, 23.8% and 5.6%, respectively. The rates of abnormal semen parameters recorded among patients infected with mycoplasma were for volume (22.2%-25%), viscosity (29.6%-43.5%), pH (64.7%-72.9%), motility (80.8%-93.8%), morphology (36.3%-47.9%), sperm concentration (53.3%-58.3%) and leukocyte count (51.4%-58.3%). Frequency of U. urealyticum infection was higher than that of M. hominis. Mycoplasma infections were associated with disorders of pH, motility and sperm concentration. In addition M. hominis infection affected spermatozoa morphology. Therefore, screening of U. urealyticum and M. hominis for routine semen analysis is clinically relevant in Abidjan. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | CLINICAL RESEARCH | INFERTILITY | SEMEN | SPERMATOZOA | BACTERIAL AND FUNGAL DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Reproduction | Seminal Vesicles | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Germ Cells | Infections | Diseases