final program.qxd - Parallels Plesk Panel

FP 2.5
Morbidity and mortality by baseline CD4 cell count during the first months following
HAART initiation in HIV-infected adults in Abidjan, Côte d'Ivoire
Raoul Moh 1 , Christine Danel 1 , Albert Minga 1 , Amani Anzian 1 , Olivier Ba-Gomis2,
Jonas Séri 3, Gustave Nzunetu 4 , Delphine Gabillard 5 , Souleymane Sorho 1 ,
Emmanuel Bissagnéné 4 , Roger Salamon 5 , Serge Eholié 4 , Xavier Anglaret 5 ,
and the Trivacan ANRS 1269 trial team
1
Programme PACCI, Abidjan, Côte d'Ivoire
2
Centre de Diagnostic et de recherches sur le SIDA (CIRBA), CHU de Treichville, Abidjan
3
Unité de soins Ambulatoires et de Conseils
4Service des Maladies infectieuses et Tropicales, CHU de Treichville, Abidjan 5INSERM
U.593 , Université Victor Segalen Bordeaux 2, Bordeaux, France
Objectives: To estimate the incidence of severe morbidity and mortality by baseline CD 4
cell count in sub-Saharan African HIV-infected adults during the first months following the
initiation of highly active antiretroviral therapy (HAART).
Methods: HAART-naïve HIV-infected adults were included in the pre-randomisation phase
of a randomised controlled trial of structured treatment interruption (STI) in Abidjan. The
main inclusion criterion was a CD 4 count at 150-350/mm 3 or a CD 4 percentage at
12.5%- 20%. After inclusion, participants received a continuous HAART. Those patients
with criteria for HAART success after at least 6 and at most 18 months of continuous
HAART in the pre-randomised phase were randomised into the STI trial. We report here
mortality and severe morbidity under continuous HAART during the pre-randomisation
phase. Severe morbidity was defined as any WHO stage 3 or 4-defining morbidity.
Results: From December 2002 to April 2004, 840 patients (76 % women, median age 34
years, baseline CD4 < 200/mm 3 :29%, at 200-350/mm 3 :52% and > 350/mm 3 : 18%) started
either ZDV-3TC-EFV (88%) or ZDV-3TC-IDV/r (12%). The median follow-up on
continuous HAART is the pre-randomisation phase was 8.1 months (interquartile range
[IQR] 7.1;13.4). 2% of patients were lost-to-follow-up. In patients with baseline
CD4≥350/mm 3 , 200-350/mm 3 , and