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Roland Landman,
M B Diallo, N F Ngom Gueye,
C Toure Kane,
S Mboup,
M B Koita Fall,
B Ndiaye,
G Peytavin,
Y Bennai,
A Benalycherif,
P M Girard,
P S Sow
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ABSTRACT: The use of ritonavir as a protease inhibitor boost is rare in sub-Saharan Africa because a heat-stable formula is not available. We report the results of an open-label pilot trial with unboosted atazanavir in combination with lamivudine and didanosine as first-line therapy conducted in Senegal. Treatment-naive HIV-1 infected adult patients without active opportunistic disease were included. The primary endpoint was the proportion of patients with plasma HIV-1 RNA <400 copies/ml at week 48. Forty patients (12 men and 28 women; mean age +/- SD: 40 +/- 9 years) were included. Treatment was changed during the study for two patients (pregnancy, tuberculosis); one patient was lost to follow-up and one patient died (gastroenteritis with cachexia). At week 48, 78% [95% confidence interval (CI): 65-90%] and 68% (95% CI: 53-82%) of the patients had HIV-1 RNA <400 and <50 copies/ml, respectively (intent-to-treat analysis; not completer = failure). Among the seven patients with HIV-1 RNA >or=400 copies/ml at week 48, five were not compliant; genotyping analysis (n = 4) did not reveal a major mutation for protease inhibitors. The mean CD4 cell count change from baseline to week 48 was +238 +/- 79 cells/mm(3). The combination of unboosted atazanavir with lamivudine and didanosine was efficient and well tolerated in HIV-1-infected patients with results similar to those observed in Northern countries. These results suggest that unboosted atazanavir with its high genetic barrier could be a valuable alternative to NNRTIs in resource-limited countries in some HIV-1-infected patients in case of compliance issues with NNRTIs, intolerance to NNRTIs, resistance mutations to NNRTIs, in women with childbearing potential, or as a maintenance therapy in patients with virological suppression.
AIDS research and human retroviruses 05/2010; 26(5):519-25. · 2.18 Impact Factor
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Roland Landman,
M Poupard,
M Diallo, N F Ngom Gueye,
N Diakhate,
B Ndiaye,
C Toure Kane,
A Trylesinski,
H Diop,
S Mboup,
M B Koita Fall,
E Delaporte,
A Benalycherif,
P M Girard,
P S Sow
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ABSTRACT: We report the results of a pilot open-label trial of a tenofovir (TDF)/emtricitabine (FTC)/efavirenz (EFV) combination conducted in Dakar, Senegal. Forty HIV-1-infected patients, naive of antiretroviral treatment and without active opportunistic disease, were included and followed through 96 weeks. At weeks 48 and 96, respectively, 82.5% and 85% of patients had HIV-1 RNA <400 copies/mL (72.5% and 77.5% with HIV-1 RNA <50 copies/mL). Between baseline and week 96, the mean (SD) CD4 count increased from 126 (102) to 338 (155) cells/mm(3). The mean (SD) creatinine clearance decreased from 92 (36) to 73 (19) mL/min (P = .001). Treatment adherence was at least 94% at all scheduled visits. The efficacy and tolerability of a TDF/FTC/EFV combination were high and similar to those observed in Northern countries. This drug combination can be recommended in limited-resource countries, as did the World Health Organization (WHO) and should be made readily available as a fixed-dose combination.
Journal of the International Association of Physicians in AIDS Care (JIAPAC) 09/2009; 8(6):379-84.
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H Diop-Ndiaye,
C Touré-Kane,
J F Etard,
G Lô,
Pa Diaw, N F Ngom-Gueye,
P M Gueye,
K Ba-Fall,
I Ndiaye,
P S Sow,
E Delaporte,
S Mboup
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ABSTRACT: The aim of this study was to determine hepatitis co-infection in a cohort of HIV infected patients at their inclusion in the Senegalese Initiative of ART Access. B, C, and D Hepatitis viruses serological markers were checked retrospectively on 363 stored plasma. For HBV, the Abbott laboratories equipment IMx was used to detect HBs Ag and anti Core Ab on negative HBs Ag samples. For HDV, anti Delta Ab was performed using the Abbott Murex Kit on all HBs Ag positive samples. For HCV, anti HCV Ab was detected by IMx as double screening test and confirmed by INNO-LIA(TM) HCV Core of Innogenetics laboratories. The statistical analysis was done with STATA V8. The study population was composed of 164 men and 199 women aged between 16 and 66 years. The immune and virological markers averages at their enrollment were 154 cell/mm(3) for TLCD4+ (n = 355 patients) and 4.9 log for viral load (n = 277 patients). HBs Ag was found in 61 patients or 16.8% and the prevalence of anti-HBc Ab was 83.2% (252/295). 2 patients or 3% on HBs Ag positive sample presents HBV/HDV co-infection Ab anti HCV was detects in 6 patients or 1.6% after confirmation and 2 patients had triple infection with HBV. These results showed that the prevalence of HBV and HCV in the population of persons living with HIV/AIDS in Senegal is similar to that found in the general population. Our data indicated that hepatitis pathology in the PLwHIV was essentially due to HBV. Further studies are needed to diagnose occult hepatitis in order to set up therapeutic strategies taking into account co-infections by hepatitis viruses in the ART programmes.
Journal of Medical Virology 09/2008; 80(8):1332-6. · 2.82 Impact Factor
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ABSTRACT: Efavirenz has been associated with neuropsychiatric disorders, but little is known about depression and quality of life in sub-Saharan Africa, where nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimens are still the first-line treatment recommended by the World Heath Organization (WHO) and are widely prescribed.
In a cross-sectional study, we evaluated quality of life and depression among Senegalese patients receiving efavirenz- or protease inhibitor (PI)-based regimens. Two hundred consecutive patients who had been taking highly active antiretroviral therapy (HAART) for more than 6 months were asked to complete a questionnaire.
According to the Center for Epidemiologic Studies Depression Scale (CES-D), 18% had depression (19% for patients on a PI-based regimen and 17% for patients on efavirenz-based treatment). Fifty-nine per cent of the patients reported no health problems in the past 4 weeks. A quarter of patients had sleep disorders. Moderate or slight adverse events were reported by 28.5% of patients.
Quality of life and depression scores remained good in both study groups. However, quality of life and depression should be monitored in follow-up of HIV-infected patients in sub-Saharan Africa.
HIV Medicine 04/2007; 8(2):92-5. · 3.01 Impact Factor
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ABSTRACT: In order to appreciate the antiretroviral drugs impact in the HIV positive patients with peripheral neuropathy, a clinical, electrophysiological and neurpathological study of nerve biopsies was performed.
A group of 8 HIV seropositive patients with peripheral neuropathy was compared with an other group of 10 HIV seropositive patients treated with multiple antiretroviral drugs. Electrophysiological examination with motor nerve conduction velocity (MNCV) mesure of the median and the sciatic popliteal nerve was followed by nerve biopsy. Nerve fragments carried out the neuropathological technics for morphological examination.
Eighteen seropositive HIV patients (16 HIV-1 and 2 HIV-2) were included in this study. Six patients among them had motor and sensitive neuropathy of the four limbs and 2 patients had sensitive neuropathy associated with pyramidal signs. In fine, 1 patient had sensitive neuropathy with distal amyotrophy of the four limbs. Slow MNCV was observed in all the patients and more severe in the lower limbs. Nerve were unexciting in the lower limbs in 2 patients. Nerve biopsy showed severe axonal loss in all the patients treated but one. They associated axonal lesion in 5 cases and myelinated lesions in 2 cases. Two patients non treated had normal nerve biopsy. Axonal loss was mild in 2 cases and very severe in one case associated with non inflammatory demyelinated lesions.
we observed more severe and more frequent nerve lesions in treated patients than in no treated patients, as at the clinical, electrophysiological and neuropathological examination. Antiretroviral drugs cause more frequently pain motor and sensitive neuropathies at usual posologies. The occurence of recrudescence of pain peripheral neuropathy under antiretroviral treatment allows to reconsider drugs posologies.
Bulletin de la Société médicale d'Afrique noire de langue française 02/2005; 50(3):176-82.
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ABSTRACT: Antiretroviral therapy has dramatically changed the natural history of HIV infection. The aim of this study was to evaluate the effectiveness and tolerance of Non Nucleosidic Reverse Trancriptase Inhibitors containing regimens in HIV-1 infection.
This is a retrospective chart review of 257 HIV-1 infected patients followed in the infectious clinic ward of fann, from august 1998 to February 2002.
Overall 195 patients (75.87%) were on efavirenz and 62 (25.2%) on nevirapine, with a male predominance (sex-ratio = 1.44). Baseline HIV-1 viral load was higher in efavirene group (p = 0.03). The two groups were comparable for immune restoration, tolerance, rate of treatment discontinuation and letality. The viral suppression was greater in efavirenz group at month 6 (p = 0.04).
Non nucleosidic reverse transcriptase inhibitor containing regimens are effective and well tolerated. Those results make them suitable for first line therapy in HIV-1-infection.
Bulletin de la Société médicale d'Afrique noire de langue française 02/2005; 50(3):202-7.
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N.C. Touré Kane,
Laurence Vergne,
Christian Laurent,
N. Diakhaté, N F Ngom Gueye,
P M Gueye,
M. Diouf,
P S Sow,
M A Faye,
Florian Liégeois,
A. Ndir,
Martine Peeters,
I Ndoye,
S Mboup,
Eric Delaporte
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Christian Laurent, N F Ngom Gueye,
N. Diakhaté,
P M Gueye,
M. Diouf,
Isabelle Lanièce,
N.C. Touré Kane,
A. Ndir,
B. Abraham,
Florian Liégeois,
M. Awa Faye,
S Mboup,
Eric Delaporte,
I Ndoye,
P S Sow
