Baseline characteristics, response to and outcome of antiretroviral therapy among patients with HIV-1, HIV-2 and dual infection in Burkina Faso

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• 作者：Katie Harries ; Rony Zachariah ; Marcel Manzi ; Peter Firmenich ; Richard Mathela ; Joseph Drabo ; G. Onadja ; Line Arnould ; Anthony Harries
• 关键词：HIV-1 ; HIV-2 ; Antiretroviral therapy ; Treatment response ; Treatment outcome ; Burkina Faso
• 刊名：Transactions of the Royal Society of Tropical Medicine and Hygiene
• 出版年：2010
• 出版时间：February 2010
• 年：2010
• 卷：104
• 期：2
• 页码：154-161
• 全文大小：338 K

文摘

Summary

In an urban district hospital in Burkina Faso we investigated the relative proportions of HIV-1, HIV-2 and HIV-1/2 among those tested, the baseline sociodemographic and clinical characteristics, and the response to and outcome of antiretroviral therapy (ART). A total of 7368 individuals (male = 32 % ; median age = 34 years) were included in the analysis over a 6 year period (2002–2008). The proportions of HIV-1, HIV-2 and dual infection were 94 % , 2.5 % and 3.6 % , respectively. HIV-1-infected individuals were younger, whereas HIV-2-infected individuals were more likely to be male, have higher CD4 counts and be asymptomatic on presentation. ART was started in 4255 adult patients who were followed up for a total of 8679 person-years, during which time 469 deaths occurred. Mortality differences by serotype were not statistically significant, but were generally worse for HIV-2 and HIV-1/2 after controlling for age, CD4 count and WHO stage. Among severely immune-deficient patients, mortality was higher for HIV-2 than HIV-1. CD4 count recovery was poorest for HIV-2. HIV-2 and dually infected patients appeared to do less well on ART than HIV-1 patients. Reasons may include differences in age at baseline, lower intrinsic immune recovery in HIV-2, use of ineffective ART regimens (inappropriate prescribing) by clinicians, and poor drug adherence.