Anthropometric and immunological success of antiretroviral therapy and prediction of virological success in west African adults.: Predictors of virological success of ART in Abidjan
| العنوان: | Anthropometric and immunological success of antiretroviral therapy and prediction of virological success in west African adults.: Predictors of virological success of ART in Abidjan |
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| المؤلفون: | Serge Eholié, Christine Danel, Catherine Seyler, Delphine Gabillard, Souleymane Sorho, Xavier Anglaret, François Rouet, André Inwoley, Eugène Messou, Raoul Moh |
| المساهمون: | Epidémiologie, santé publique et développement, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR99-ISPED, Programme PAC-CI, ANRS France Recherche Nord & sud Sida-hiv hépatites, Centre de recherche et de Diagnostic sur le Sida [Abidjan, Côte d'Ivoire] (CeDreS), Centre Hospitalier Universitaire de Treichville [Abidjan, Côte d'Ivoire] (CHU de Treichville), Service des Maladies Infectieuses et Tropicales (SMIT), CHU de Treichville |
| المصدر: | Bulletin of the World Health Organization Bulletin of the World Health Organization, World Health Organization, 2008, 86 (6), pp.435-42 |
| بيانات النشر: | WHO Press, 2008. |
| سنة النشر: | 2008 |
| مصطلحات موضوعية: | Adult, Male, sub-Saharan Africa, medicine.medical_specialty, HAART, Population, HIV Infections, body mass index, CD4 count, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Antiretroviral Therapy, Highly Active, Internal medicine, Outcome Assessment, Health Care, adults, medicine, Humans, 030212 general & internal medicine, Prospective cohort study, education, 2. Zero hunger, 0303 health sciences, education.field_of_study, virological success, Anthropometry, predictive value, 030306 microbiology, business.industry, Research, Public Health, Environmental and Occupational Health, Viral Load, CD4 Lymphocyte Count, 3. Good health, Surgery, Cote d'Ivoire, Treatment Outcome, Cohort, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Viral load, Body mass index, Forecasting, Cohort study |
| الوصف: | International audience; OBJECTIVE: 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. METHODS: In a cohort of 622 adults in Abidjan, C?d'Ivoire, we calculated the sensitivity, specificity and predictive values of BMI and CD4 for treatment success defined as viral-load undetectability (< 300 copies/ml) as gold standard. FINDINGS: 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/ml (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. CONCLUSION: 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. |
| تدمد: | 0042-9686 |
| DOI: | 10.2471/blt.07.042911 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3b8a54cf3b6d64f95a10e2c72324d126 https://doi.org/10.2471/blt.07.042911 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....3b8a54cf3b6d64f95a10e2c72324d126 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00429686 |
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| DOI: | 10.2471/blt.07.042911 |