西非寻求治疗和抗逆转录病毒疗法的HIV-2以及HIV-1/HIV-2双重血清阳性成年人的特征：IeDEA-西非HIV-2队列研究
Characteristics of HIV-2 and HIV-1/HIV-2 Dually Seropositive Adults in West Africa Presenting for Care and Antiretroviral Therapy: The IeDEA-West Africa HIV-2 Cohort Study.
作者信息
Ekouevi Didier K, Balestre Eric, Coffie Patrick A, Minta Daouda, Messou Eugene, Sawadogo Adrien, Minga Albert, Sow Papa Salif, Bissagnene Emmanuel, Eholie Serge P, Gottlieb Geoffrey S, Dabis François, Zannou Djimon Marcel, Ahouada Carin, Akakpo Jocelyn, Ahomadegbé Christelle, Bashi Jules, Gougounon-Houéto Alice, Azon-Kouanou Angèle, Houngbé Fabien, Koumakpaï Sikiratou, Alihonou Florence, d'Almeida Marcelline, Hodonou Irvine, Hounhoui Ghislaine, Sagbo Gracien, Tossa-Bagnan Leïla, Adjide Herman, Drabo Joseph, Bognounou René, Dienderé Arnaud, Traore Eliezer, Zoungrana Lassane, Zerbo Béatrice, Sawadogo Adrien Bruno, Zoungrana Jacques, Héma Arsène, Soré Ibrahim, Bado Guillaume, Tapsoba Achille, Yé Diarra, Kouéta Fla, Ouedraogo Sylvie, Ouédraogo Rasmata, Hiembo William, Gansonré Mady, Messou Eugène, Gnokoro Joachim Charles, Koné Mamadou, Kouakou Guillaume Martial, Bosse Clarisse Amani, Brou Kouakou, Assi Achi Isidore, Chenal Henri, Hawerlander Denise, Soppi Franck, Minga Albert, Abo Yao, Bomisso Germain, Eholié Serge Paul, Amego Mensah Deborah Noelly, Andavi Viviane, Diallo Zelica, Ello Frédéric, Tanon Aristophane Koffi, Koule Serge Olivier, Anzan Koffi Charles, Guehi Calixte, Aka Edmond Addi, Issouf Koffi Ladji, Kouakou Jean-Claude, N'gbeche Marie-Sylvie, Touré Pety, Avit-Edi Divine, Kouakou Kouadio, Moh Magloire, Yao Valérie Andoblé, Folquet Madeleine Amorissani, Dainguy Marie-Evelyne, Kouakou Cyrille, Méa-Assande Véronique Tanoh, Oka-Berete Gladys, Zobo Nathalie, Acquah Patrick, Kokora Marie-Berthe, Eboua Tanoh François, Timité-Konan Marguerite, Ahoussou Lucrèce Diecket, Assouan Julie Kebé, Sami Mabéa Flora, Kouadio Clémence, Renner Lorna, Goka Bamenla, Welbeck Jennifer, Sackey Adziri, Owiafe Seth Ntiri, Wejse Christian, Silva Zacarias José Da, Paulo Joao, Rodrigues Amabelia, da Silva David, Medina Candida, Oliviera-Souto Ines, Ostergaard Lars, Laursen Alex, Sodemann Morten, Aaby Peter, Fomsgaard Anders, Erikstrup Christian, Eugen-Olsen Jesper, Maïga Moussa Y, Diakité Fatoumata Fofana, Kalle Abdoulaye, Katile Drissa, Traore Hamar Alassane, Minta Daouda, Cissé Tidiani, Dembelé Mamadou, Doumbia Mohammed, Fomba Mahamadou, Kaya Assétou Soukho, Traoré Abdoulaye M, Traoré Hamady, Toure Amadou Abathina, Dicko Fatoumata, Sylla Mariam, Berthé Alima, Traoré Hadizatou Coulibaly, Koïta Anta, Koné Niaboula, N'diaye Clémentine, Coulibaly Safiatou Touré, Traoré Mamadou, Traoré Naïchata, Charurat Man, Ajayi Samuel, Dapiap Stephen, Igbinoba Festus, Benson Okwara, Adebamowo Clément, James Jesse, Osakede Philip, Olasode John, Sow Papa Salif, Diop Bernard, Manga Noël Magloire, Tine Judicael Malick, Signate Sy Haby, Ba Abou, Diagne Aida, Dior Hélène, Faye Malick, Gueye Ramatoulaye Diagne, Mbaye Aminata Diack, Patassi Akessiwe, Kotosso Awèrou, Kariyare Benjamin Goilibe, Gbadamassi Gafarou, Komi Agbo, Mensah-Zukong Kankoé Edem, Pakpame Pinuwe, Lawson-Evi Annette Koko, Atakouma Yawo, Takassi Elom, Djeha Améyo, Ephoévi-Gah Ayoko, Djibril Sherifa El-Hadj, Dabis François, Bissagnene Emmanuel, Arrivé Elise, Coffie Patrick, Ekouevi Didier, Jaquet Antoine, Leroy Valériane, Lewden Charlotte, Sasco Annie, Azani Jean-Claude, Allou Gérard, Balestre Eric, Bohossou Franck, Karcher Sophie, Gonsan Jules Mahan, Carrou Jérôme Le, Lenaud Séverin, Nchot Célestin, Malateste Karen, Yao Amon Roseamonde, Siloué Bertine, Clouet Gwenaelle, Djetouan Hugues, Doring Alexandra, Kouakou Adrienne, Rabourdin Elodie, Rivenc Jean, Anglaret Xavier, Ba Boubacar, Essanin Jean Bosco, Ciaranello Andrea, Datté Sébastien, Desmonde Sophie, Diby Jean-Serge Elvis, Gottlieb Geoffrey S, Horo Apollinaire Gninlgninrin, Kangah Serge N'zoré, Malvy Denis, Meless David, Mounkaila-Harouna Aida, Ndondoki Camille, Shiboski Caroline, Thiébaut Rodolphe
机构信息
Université Bordeaux Segalen, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, Bordeaux, France ; Programme PACCI, Abidjan, Côte d'Ivoire ; Département des Sciences Fondamentales et Santé Publique, Université de Lomé, Lomé, Togo.
出版信息
PLoS One. 2013 Jun 18;8(6):e66135. doi: 10.1371/journal.pone.0066135. Print 2013.
BACKGROUND
HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA).
METHODS
We collected data on all HIV-2 and HIV-1/HIV-2 dually seropositive patients (both ARV-naive and starting ART) and followed-up in clinical centres in the IeDEA-WA network including a total of 13 clinics in five countries: Benin, Burkina-Faso Côte d'Ivoire, Mali, and Senegal, in the West Africa region.
RESULTS
Data was merged for 1,754 patients (56% female), including 1,021 HIV-2 infected patients (551 on ART) and 733 dually seropositive for both HIV-1 and HIV 2 (463 on ART). At ART initiation, the median age of HIV-2 patients was 45.3 years, IQR: (38.3-51.7) and 42.4 years, IQR (37.0-47.3) for dually seropositive patients (p = 0.048). Overall, 16.7% of HIV-2 patients on ART had an advanced clinical stage (WHO IV or CDC-C). The median CD4 count at the ART initiation is 166 cells/mm(3), IQR (83-247) among HIV-2 infected patients and 146 cells/mm(3), IQR (55-249) among dually seropositive patients. Overall, in ART-treated patients, the CD4 count increased 126 cells/mm(3) after 24 months on ART for HIV-2 patients and 169 cells/mm(3) for dually seropositive patients. Of 551 HIV-2 patients on ART, 5.8% died and 10.2% were lost to follow-up during the median time on ART of 2.4 years, IQR (0.7-4.3).
CONCLUSIONS
This large multi-country study of HIV-2 and HIV-1/HIV-2 dual infection in West Africa suggests that routine clinical care is less than optimal and that management and treatment of HIV-2 could be further informed by ongoing studies and randomized clinical trials in this population.
背景
HIV-2在西非流行。目前缺乏关于HIV-2或HIV-1/HIV-2双重感染的诊断、管理及抗逆转录病毒治疗（ART）的循证指南。鉴于这些问题，我们在国际艾滋病流行病学数据库评估（IeDEA）框架内设计了一个西非HIV-2感染协作队列。
方法
我们收集了所有HIV-2及HIV-1/HIV-2双重血清学阳性患者（包括初治及开始接受ART治疗的患者）的数据，并在IeDEA-西非网络的临床中心进行随访，该网络包括西非地区五个国家（贝宁、布基纳法索、科特迪瓦、马里和塞内加尔）的共13家诊所。
结果
合并了1754例患者的数据（56%为女性），其中包括1021例HIV-2感染患者（551例接受ART治疗）以及733例HIV-1和HIV-2双重血清学阳性患者（463例接受ART治疗）。开始接受ART治疗时，HIV-2患者的中位年龄为45.3岁，四分位间距（IQR）：（38.3 - 51.7），双重血清学阳性患者为42.4岁，IQR（37.0 - 47.3）（p = 0.048）。总体而言，接受ART治疗的HIV-2患者中16.7%处于临床晚期（世界卫生组织IV期或美国疾病控制与预防中心C期）。HIV-2感染患者开始接受ART治疗时的CD4细胞计数中位数为166个/立方毫米，IQR（83 - 247），双重血清学阳性患者为146个/立方毫米，IQR（55 - 249）。总体而言，在接受ART治疗的患者中，HIV-2患者接受ART治疗24个月后CD4细胞计数增加了126个/立方毫米，双重血清学阳性患者增加了169个/立方毫米。在接受ART治疗的551例HIV-2患者中，在ART治疗的中位时间2.4年（IQR（0.7 - 4.3））内，5.8%死亡，10.2%失访。
结论
这项针对西非HIV-2及HIV-1/HIV-2双重感染的大型多国研究表明，常规临床护理并非最佳，该人群中正在进行的研究和随机临床试验可为HIV-2的管理和治疗提供更多信息。
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