Konan Bérenger, de Mendoza Carmen, Kouadio Christ-Hermannn, Martial-Yao Eric, de Jesús Fernando, Corral Octavio, Soriano Vicente
Centre Médico-Social Walé, Yamoussoukro, Ivory Coast
Department of Internal Medicine, Puerta de Hierro University Hospital, Madrid, Spain
AIDS Rev. 2024 Nov 7;26(4):151-157. doi: 10.24875/AIDSRev.M24000076.
Simian immunodeficiency viruses (SIV) infecting chimpanzees (SIVcpz) and sooty mangabeys (SIVsm) are, respectively, the biological precursors of human immunodeficiency viruses (HIV) Types 1 and 2. Former French colonies in West Africa are the regions where retroviruses first jumped from primates to humans. Ivory Coast is nowadays a country of over 29 million people, being 2% (580,000) persons living with HIV (PLWH). However, one-quarter remains undiagnosed. Heterosexual transmission is by far the most frequent mechanism of HIV acquisition and women exhibit higher rates of infection than men. Despite preventive measures, HIV infection in children throughout breastfeeding remains significant. The proportion of PLWH carrying HIV-1 is rising whereas conversely HIV-2 carriers are steadily declining. A nationwide survey conducted on earlier 2024 showed that a total of 188,880 PLWH were on follow-up. HIV-1 infection was found in 163,947, HIV-2 in 5,114, and coinfection in 3,182. HIV type was not reported for 7,500. Antiretroviral therapy with tenofovir, lamivudine, and dolutegravir is by far the most frequently prescribed regimen in Ivory Coast (n = 168,543). Viral suppression is recognized in 94.3% of treated PLWH, despite one-third acknowledging unwanted treatment interruptions after failure of stock supplies. Given shared transmission routes with HIV, coinfection with other human retroviruses such as Human T-lymphotropic virus type-1 (HTLV-1) and/or hepatitis viruses B, C, and delta are frequent in Ivory Coast. Coinfections remain largely undiagnosed and poorly managed. In summary, the HIV pandemic caused by both HIV-1 and HIV-2 is a major public health challenge in Ivory Coast, where strategies for expanding diagnosis, sustain antiretroviral treatment, and manage coinfections warrant further efforts.
感染黑猩猩的猴免疫缺陷病毒（SIVcpz）和感染乌黑白眉猴的猴免疫缺陷病毒（SIVsm）分别是人类免疫缺陷病毒1型和2型的生物学前身。西非的前法国殖民地是逆转录病毒首次从灵长类动物传播到人类的地区。如今，科特迪瓦有超过2900万人口，其中有2%（58万）的人感染了艾滋病毒（PLWH）。然而，四分之一的感染者仍未被诊断出来。异性传播是目前感染艾滋病毒最常见的途径，女性的感染率高于男性。尽管采取了预防措施，但通过母乳喂养导致儿童感染艾滋病毒的情况仍然很严重。感染艾滋病毒1型的艾滋病毒感染者比例在上升，而感染艾滋病毒2型的感染者比例则在稳步下降。2024年初进行的一项全国性调查显示，共有188,880名艾滋病毒感染者正在接受随访。其中，163,947人感染了艾滋病毒1型，5,114人感染了艾滋病毒2型，3,182人同时感染了两种病毒。7,500人的艾滋病毒类型未报告。在科特迪瓦，由替诺福韦、拉米夫定和多替拉韦组成的抗逆转录病毒疗法是目前最常用的治疗方案（n = 168,543）。在接受治疗的艾滋病毒感染者中，94.3%的人实现了病毒抑制，尽管三分之一的人承认在药物供应中断后出现了非预期的治疗中断。鉴于艾滋病毒的传播途径与其他病毒相同，在科特迪瓦，与其他人类逆转录病毒如人类嗜T淋巴细胞病毒-1型（HTLV-1）和/或乙型、丙型和丁型肝炎病毒的合并感染很常见。合并感染在很大程度上仍未得到诊断，治疗也很不完善。总之，由艾滋病毒1型和艾滋病毒2型引起的艾滋病毒大流行是科特迪瓦面临的一项重大公共卫生挑战，在扩大诊断、维持抗逆转录病毒治疗和管理合并感染方面的策略仍需进一步努力。
