Background: The biological profile of HIV-positive patients is essential for diagnosing treatment failure and the prognosis of infection. We determined the virological and immunological profiles and biological anomalies of HIV-positive people on antiretroviral therapy (ART) in Bangui, Central Afri-can Republic. Methods: We conducted an analytical, descriptive study be-tween 4 April and 30 September 2017 of all patients who had received ART for more than 12 months and who attended the Medical Analysis Laboratory of the Institut Pasteur in Bangui for a complete biological work-up, including viral load. A blood sample was taken for quantification of RNA HIV-1, CD4 lymphocytes and blood count in two tubes containing ethylenediamine te-traacetic acid, and another sample was taken in a dry tube for measurement of creatinine and transaminases. Results: The total population comprised 1748 patients, with a mean age of 38.7 years (±14.3; median, 41 years; range, 2 - 79 years); 33.3% of patients were between 40 and 49 years old. Females predo-minated (71.3%), for a sex ratio of 0.4. Immunological failure was observed in 20.2% of patients (CD4 < 200 cells/μL), and 44.5% of patients had a load of RNA HIV-1 ≥ 1000 copies/mL. The main haematological anomalies were anaemia (28.0%), leukopenia (26.7%), neutropenia (42.1%) and lymphopenia (27.2%). Blood creatinine was abnormal in 61.0% of patients, ALAT in 57.0% and ASAT in 66.9%. Conclusion: The abnormalities observed in this study concerned the haematopoietic system, the liver and the kidneys. As other or-gans and systems may be affected, periodic multidisciplinary biological and clinical follow-up is necessary for people living with HIV in order to improve their management.
References
[1]
UNAIDS (2017) Fact sheet World AIDS Day. UNAIDS, Geneva, 1-8.
http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf
[2]
Centers for Disease Control and Prevention. (1993) Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS among Adolescents and Adults. Morbidity and Mortality Weekly Report, 41, 1-19.
[3]
Chêne, G., Binquet, C., Moreau, J.F., Neau, D., Pellegrin, L., Malvy, D., et al. (1998) Change in CD4+ Cell Count and the Risk of Opportunistic Infection or Death after Highly Active Antiretroviral Treatment. AIDS, 12, 2313-2320.
https://doi.org/10.1097/00002030-199817000-00013
[4]
Hammer, S.M., Squires, K.E., Hugues, M.D., Grimes, J.M., Demeter, L.M., Currier, J.S., et al. (1997) A Controlled Trial of Two Nucleoside Analogues plus Indinavir in Persons with Human Immunodeficiency Virus Infection and CD4 Cell Counts of 200 per Cubic Millimeter or Less. The New England Journal of Medicine, 337, 725-733. https://doi.org/10.1056/NEJM199709113371101
[5]
Ba-Fall, K., Gueye, P.M., Lefevre, N., Fall, I.S., Said Ali Saindou, N., et al. (2004) Evolution of Antiretroviral Treatment of HIV/AIDS Infection at Dakar Main Hospital. Médecine Tropicale, 64, 292-293.
[6]
Montagnier, L. (1998) AIDS and HIV Infection. Flammarion, Paris.
[7]
Kobangue, L., Gody, J.C., Diemer, S.C.H., Biguene-Sapoua-Boka, Y., Dibere Kamba, G.D. and Bobossy Serengbe, G. (2016) Epidemiological, Clinical, Biological and Therapeutic Aspects of Children Dying on Antiretrovirals at the Bangui Pediatric Complex, Central African Republic. Revue de CAMES Science de Santé, 4, 15-18.
[8]
Beuzit, Y., Bougarel, J. and Ngouonimba, J. (1992) Peripheral and Medullary Hematologic Changes in HIV Infection in Central Africa. Médecine Tropicale, 52, 193-199.
[9]
Aceti, A., Pasquazzi, C., Zechini, B., De Bac, C., Liverhaart Group. (2002) Hepatotoxicity Development during Antiretroviral Therapy Containing Protease Inhibitors in Patients with HIV. The Role of Hepatitis B and C Virus Infection. Journal of AIDS, 29, 41-48. https://doi.org/10.1097/00042560-200201010-00005
[10]
Carr, A. and Cooper, D.A. (2000) Adverse Effects of Antiretroviral Therapy. Lancet, 356, 1423-1430. https://doi.org/10.1016/S0140-6736(00)02854-3
[11]
Malaty, L. and Kuper, J. (1999) Drug Interactions of HIV Protease Inhibitors. Drug Safety, 20, 147-169. https://doi.org/10.2165/00002018-199920020-00005
[12]
Savès, M., Vandentorren, S., Daucourt, V., Marimoutou, C., Dupon, M., Couzigou, P., et al. (1999) Severe Hepatic Cytolysis: Incidence and Risk Factors in Patients Treated by Antiretroviral Combinations. Aquitaine Cohort, France, 1996-1998. AIDS, 13, l15-121. https://doi.org/10.1097/00002030-199912030-00002
[13]
Mouala, C., Kaba-Mebri, J., Wata, J.B. and Rey, J.L. (2006) Factors Associated with Good Adherence in HIV-Infected Patients in Bangui. Cah Etudes Rech Francophones Santé, 16, 119-130.
[14]
WHO (2016) Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach. 2nd Edition, WHO, Geneva.
[15]
WHO (2013) Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach. WHO, Geneva.
[16]
Loua, A., Dramou, C.D., Haba, N.Y., Magassouba, F.B., Lamah, M., Camara, A., Cissé, M., et al. (2011) Hematologic Profile of HIV-Infected Patients in Conakry. Hématologie, 17, 365-369.
[17]
Mouhari-Touré, A., Patassi, A., Nabroulala, K.T., Djadou, K.E., Edou, K., Nyametso, D., et al. (2011) Biological Profile of Adult HIV-Infected Patients at Initiation of Treatment in Togo. Medecine Et Maladies Infectieuses, 41, 229-234.
https://doi.org/10.1016/j.medmal.2010.11.007
[18]
Lozès, E., Ahoussinou, C., Agassounou-Tchibozo Djikpo, M., Dahouegnon, E., Ahossouhe, N., Acoty, A. and de Souza, C. (2012) Variability of CD4 Cell Count and Viral Load in People Living with HIV on Antiretroviral Treatment: Case of Saint Jean De Dieu Hospital in Tanguieta (Benin). International Journal of Biological and Chemical Sciences, 6, 650-656.
[19]
Malyangu, E., Abayomi, E.A., Adewuyi, J. and Coutts, A.M. (2000) AIDS Is Now the Commonest Clinical Condition Associated with Multilineage Blood Cytopenia in a Central Referral Hospital in Zimbabwe. Central African Journal of Medicine, 46, 59-61. https://doi.org/10.4314/cajm.v46i3.8525
[20]
Bain, B.J. (1997) The Haematological Features of HIV Infection. British Journal of Haematology, 99, 1-8. https://doi.org/10.1046/j.1365-2141.1997.2943111.x
[21]
Coso, D. and Gastaut, J.A. (2005) Non-Tumor Hematological Abnormalities during HIV Infection. In: Sebahoun, G., Ed., Hématologie clinique et biologique, 2nd Edition, Editions Arnette, Paris, 319-322.
[22]
Nacoulma, E.W.C., Some, Y., Tieno, H., Diallo, I., Zoungrana, A., Bougnounou, R., Ouédraogo, C., et al. (2007) Evolution of Hematologic Parameters during Antiretroviral Therapy in HIV-Infected Patients in Burkina Faso. Bulletin De La Societe De Pathologie Exotique, 100, 271-274.
[23]
Erhabor, O., Ejele, O.A., Nwauche, C.A. and Buseri, F.I. (2005) Some Haematological Parameters in Human Immunodeficiency Virus (HIV) Infected Africans: The Nigerian Perspective. Nigerian Journal of Medicine, 14, 33-38.