Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

Long term virological, immunological and mortality outcomes in a cohort of HIV-infected female sex workers treated with highly active antiretroviral therapy in Africa

Authors: Charlotte Huet, Abdoulaye Ouedraogo, Issouf Konaté, Isidore Traore, François Rouet, Antoinette Kaboré, Anselme Sanon, Philippe Mayaud, Philippe Van de Perre, Nicolas Nagot

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

Concerns have been raised that marginalised populations may not achieve adequate compliance to antiretroviral therapy. Our objective was to describe the long-term virological, immunological and mortality outcomes of providing highly active antiretroviral therapy (HAART) with strong adherence support to HIV-infected female sex workers (FSWs) in Burkina Faso and contrast outcomes with those obtained in a cohort of regular HIV-infected women.

Methods

Prospective study of FSWs and non-FSWs initiated on HAART between August 2004 and October 2007. Patients were followed monthly for drug adherence (interview and pill count), and at 6-monthly intervals for monitoring CD4 counts and HIV-1 plasma viral loads (PVLs) and clinical events.

Results

95 women, including 47 FSWs, were followed for a median of 32 months (interquartile range [IQR], 20-41). At HAART initiation, the median CD4 count was 147 cells/μl (IQR, 79-183) and 144 cells/μl (100-197), and the mean PVLs were 4.94 log10copies/ml (95% confidence interval [CI], 4.70-5.18) and 5.15 log10 copies/ml (4.97-5.33), in FSWs and non-FSWs, respectively. Four FSWs died during follow-up (mortality rate: 1.7 per 100 person-years) and none among other women. At 36 months, the median CD4 count increase was 230 cells/μl (IQR, 90-400) in FSWs vs. 284 cells/μl (193-420) in non-FSWs; PVL was undetectable in 81.8% (95% CI, 59.7-94.8) of FSWs vs. 100% (83.9-100) of non-FSWs; and high adherence to HAART (> 95% pills taken) was reported by 83.3% (95% CI, 67.2-93.6), 92.1% (95% CI, 78.6-98.3), and 100% (95% CI, 54.1-100) of FSWs at 6, 12, and 36 months after HAART initiation, respectively, with no statistical difference compared to the pattern observed among non-FSWs.

Conclusions

Clinical and biological benefits of HAART can be maintained over the long term among FSWs in Africa and could also lead to important public health benefits.
Appendix
Available only for authorised users
Literature
1.
Djomand G, Roels T, Ellerbrock T, Hanson D, Diomande F, Monga B, Maurice C, Nkengasong J, Konan-Koko R, Kadio A, Wiktor S, Lackritz E, Saba J, Chorba T: Virologic and immunologic outcomes and programmatic challenges of an antiretroviral treatment pilot project in Abidjan, Cote d'Ivoire. AIDS. 2003, 17 (Suppl 3): S5-15.CrossRefPubMed
2.
Seyler C, Anglaret X, Dakoury-Dogbo N, Messou E, Toure S, Danel C, Diakite N, Daudie A, Inwoley A, Maurice C, Tonwe-Gold B, Rouet F, N'Dri-Yoman T, Salamon R: Medium-term survival, morbidity and immunovirological evolution in HIV-infected adults receiving antiretroviral therapy, Abidjan, Cote d'Ivoire. Antivir Ther. 2003, 8: 385-393.PubMed
3.
Laurent C, Ngom Gueye NF, Ndour CT, Gueye PM, Diouf M, Diakhate N, Toure Kane NC, Laniece I, Ndir A, Vergne L, Ndoye I, Mboup S, Sow PS, Delaporte E: Long-term benefits of highly active antiretroviral therapy in Senegalese HIV-1-infected adults. J Acquir Immune Defic Syndr. 2005, 38: 14-17. 10.1097/00126334-200501010-00003.CrossRefPubMed
4.
Boileau C, Nguyen VK, Sylla M, Machouf N, Chamberland A, Traore HA, Niamba PA, Diallo I, Maiga M, Cisse M, Rashed S, Tremblay C: Low prevalence of detectable HIV plasma viremia in patients treated with antiretroviral therapy in Burkina Faso and Mali. J Acquir Immune Defic Syndr. 2008, 48 (4): 476-484. 10.1097/QAI.0b013e31817dc416.CrossRefPubMed
5.
Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG: Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009, 373 (9657): 48-57. 10.1016/S0140-6736(08)61697-9.CrossRefPubMed
6.
Ouedraogo A, Nagot N, Vergne L, Konate I, Weiss HA, Defer MC, Foulongne V, Sanon A, Andonaba JB, Segondy M, Mayaud P, Van de Perre P: Impact of suppressive herpes therapy on genital HIV-1 RNA among women taking antiretroviral therapy: a randomized controlled trial. AIDS. 2006, 20: 2305-2313. 10.1097/QAD.0b013e328010238d.CrossRefPubMed
7.
Wilson DP, Law MG, Grulich AE, Cooper DA, Kaldor JM: Relation between HIV viral load and infectiousness: a model-based analysis. Lancet. 2008, 372: 314-320. 10.1016/S0140-6736(08)61115-0.CrossRefPubMed
8.
Modjarrad K, Chamot E, Vermund SH: Impact of small reductions in plasma HIV RNA levels on the risk of heterosexual transmission and disease progression. AIDS. 2008, 22: 2179-2185. 10.1097/QAD.0b013e328312c756.CrossRefPubMedPubMedCentral
9.
Fideli US, Allen SA, Musonda R, Trask S, Hahn BH, Weiss H, Mulenga J, Kasolo F, Vermund SH, Aldrovandi GM: Virologic and immunologic determinants of heterosexual transmission of human immunodeficiency virus type 1 in Africa. AIDS Res Hum Retroviruses. 2001, 17: 901-910. 10.1089/088922201750290023.CrossRefPubMedPubMedCentral
10.
Quinn TC, Wawer MJ, Sewankambo N, Serwadda D, Li C, Wabwire-Mangen F, Meehan MO, Lutalo T, Gray RH: Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med. 2000, 342: 921-929. 10.1056/NEJM200003303421303.CrossRefPubMed
11.
De Cock KM, Gilks CF, Lo YR, Guerma T: Can antiretroviral therapy eliminate HIV transmission?. Lancet. 2009, 373 (9657): 7-9. 10.1016/S0140-6736(08)61732-8.CrossRefPubMed
12.
Nagot N, Ouangre A, Ouedraogo A, Cartoux M, Huygens P, Defer MC, Zekiba T, Meda N, Van de Perre P: Spectrum of commercial sex activity in Burkina Faso: classification model and risk of exposure to HIV. J Acquir Immune Defic Syndr. 2002, 29: 517-521.CrossRefPubMed
13.
Alary M, Lowndes CM: The central role of clients of female sex workers in the dynamics of heterosexual HIV transmisson in sub-Saharan Africa. AIDS. 2004, 18: 945-947. 10.1097/00002030-200404090-00013.CrossRefPubMed
14.
Morison L, Weiss HA, Buve A, Carael M, Abega SC, Kaona F, Kanhonou L, Chege J, Hayes RJ: Commercial sex and the spread of HIV in four cities in sub-Saharan Africa. Aids. 2001, 15 (Suppl 4): S61-69.CrossRefPubMed
15.
Cote AM, Sobela F, Dzokoto A, Nzambi K, Asamoah-Adu C, Labbe AC, Masse B, Mensah J, Frost E, Pepin J: Transactional sex is the driving force in the dynamics of HIV in Accra, Ghana. AIDS. 2004, 18: 917-925. 10.1097/00002030-200404090-00009.CrossRefPubMed
16.
Alary M, Mukenge-Tshibaka L, Bernier F, Geraldo N, Lowndes CM, Meda H, Gnintoungbe CA, Anagonou S, Joly JR: Decline in the prevalence of HIV and sexually transmitted diseases among female sex workers in Cotonou, Benin, 1993-1999. AIDS. 2002, 16: 463-470. 10.1097/00002030-200202150-00019.CrossRefPubMed
17.
Ghys PD, Diallo MO, Ettiegne-Traore V, Kale K, Tawil O, Carael M, Traore M, Mah-Bi G, De Cock KM, Wiktor SZ, Laga M, Greenberg AE: Increase in condom use and decline in HIV and sexually transmitted diseases among female sex workers in Abidjan, Cote d'Ivoire, 1991-1998. AIDS. 2002, 16: 251-258. 10.1097/00002030-200201250-00015.CrossRefPubMed
18.
Nagot N, Ouedraogo A, Ouangre A, Cartoux M, Defer MC, Meda N, Van de Perre P: Is sexually transmitted infection management among sex workers still able to mitigate the spread of HIV infection in West Africa?. J Acquir Immune Defic Syndr. 2005, 39: 454-458. 10.1097/01.qai.0000152399.54648.b9.CrossRefPubMed
19.
Nagot N, Ouedraogo A, Foulongne V, Konate I, Weiss HA, Vergne L, Defer MC, Djagbare D, Sanon A, Andonaba JB, Becquart P, Segondy M, Vallo R, Sawadogo A, Van de Perre P, Mayaud P: Reduction of HIV-1 RNA levels with therapy to suppress herpes simplex virus. N Engl J Med. 2007, 356: 790-799. 10.1056/NEJMoa062607.CrossRefPubMed
20.
World Health Organization: Safe and effective use of antiretroviral treatments in adults with particular reference to resource limited settings. 2000, Geneva: WHO/UNAIDS
21.
22.
Meda N, Gautier-Charpentier L, Soudre RB, Dahourou H, Ouedraogo-Traore R, Ouangre A, Bambara A, Kpozehouen A, Sanou H, Valea D, Ky F, Cartoux M, Barin F, Van de Perre P: Serological diagnosis of human immuno-deficiency virus in Burkina Faso: reliable, practical strategies using less expensive commercial test kits. Bull World Health Organ. 1999, 77: 731-739.PubMedPubMedCentral
23.
Joint United Nations Programme on HIV/AIDS (UNAIDS)-WHO. Revised recommendations for the selection and use of HIV antibody tests. Wkly Epidemiol Rec. 1997, 72: 81-87.
24.
Rouet F, Chaix ML, Nerrienet E, Ngo-Giang-Huong N, Plantier JC, Burgard M, Peeters M, Damond F, Ekouevi DK, Msellati P, Ferradini L, Rukobo S, Marechal V, Schvachsa N, Wakrim L, Rafalimanana C, Rakotoambinina B, Viard JP, Seigneurin JM, Rouzioux C: Impact of HIV-1 genetic diversity on plasma HIV-1 RNA Quantification: usefulness of the Agence Nationale de Recherches sur le SIDA second-generation long terminal repeat-based real-time reverse transcriptase polymerase chain reaction test. J Acquir Immune Defic Syndr. 2007, 45: 380-388. 10.1097/QAI.0b013e3180640cf5.CrossRefPubMed
25.
van Dyck E, Buve A, Weiss HA, Glynn JR, Brown DW, De Deken B, Parry J, Hayes RJ: Performance of commercially available enzyme immunoassays for detection of antibodies against herpes simplex virus type 2 in African populations. J Clin Microbiol. 2004, 42 (7): 2961-2965. 10.1128/JCM.42.7.2961-2965.2004.CrossRefPubMedPubMedCentral
26.
Agence Nationale de Recherche sur le Sida et les hépatites virales: Echelle ANRS de Cotation de la Gravité des Evénements Indésirables chez l'adulte. Version no. 6 du 9 septembre 2003
27.
Brinkhof MW, Dabis F, Myer L, Bangsberg DR, Boulle A, Nash D, et al: Early loss of HIV-infected patients on potent antiretroviral therapy programmes in lower-income countries. Bull World Health Organ. 2008, 86: 559-567. 10.2471/BLT.07.044248.CrossRefPubMedPubMedCentral
28.
Etard JF, Ndiaye I, Thierry-Mieg M, Gueye NF, Gueye PM, Laniece I, Dieng AB, Diouf A, Laurent C, Mboup S, Sow PS, Delaporte E: Mortality and causes of death in adults receiving highly active antiretroviral therapy in Senegal: a 7-year cohort study. AIDS. 2006, 20: 1181-1189. 10.1097/01.aids.0000226959.87471.01.CrossRefPubMed
29.
Toure S, Kouadio B, Seyler C, Traore M, Dakoury-Dogbo N, Duvignac J, Diakite N, Karcher S, Grundmann C, Marlink R, Dabis F, Anglaret X: Rapid scaling-up of antiretroviral therapy in 10,000 adults in Cote d'Ivoire: 2-year outcomes and determinants. AIDS. 2008, 22: 873-882. 10.1097/QAD.0b013e3282f768f8.CrossRefPubMedPubMedCentral
30.
Boulle A, Bock P, Osler M, Cohen K, Channing L, Hilderbrand K, Mothibi E, Zweigenthal V, Slingers N, Cloete K, Abdullah F: Antiretroviral therapy and early mortality in South Africa. Bull World Health Organ. 2008, 86: 678-687. 10.2471/BLT.07.045294.CrossRefPubMedPubMedCentral
31.
Braitstein P, Brinkhof MW, Dabis F, Schechter M, Boulle A, Miotti P, Wood R, Laurent C, Sprinz E, Seyler C, Bangsberg DR, Balestre E, Sterne JA, May M, Egger M: Mortality of HIV-1-infected patients in the first year of antiretroviral therapy: comparison between low-income and high-income countries. Lancet. 2006, 367 (9513): 817-824.CrossRefPubMed
32.
Lawn SD, Harries AD, Anglaret X, Myer L, Wood R: Early mortality among adults accessing antiretroviral treatment programmes in sub-Saharan Africa. AIDS. 2008, 22: 1897-1908. 10.1097/QAD.0b013e32830007cd.CrossRefPubMed
33.
Marazzi MC, Liotta G, Germano P, Guidotti G, Altan AD, Ceffa S, Lio MM, Nielsen-Saines K, Palombi L: Excessive early mortality in the first year of treatment in HIV type 1-infected patients initiating antiretroviral therapy in resource-limited settings. AIDS Res Hum Retroviruses. 2008, 24: 555-560. 10.1089/aid.2007.0217.CrossRefPubMed
34.
Keiser O, Orrell C, Egger M, Wood R, Brinkhof MW, Furrer H, van Cutsem G, Ledergerber B, Boulle A: Public-health and individual approaches to antiretroviral therapy: township South Africa and Switzerland compared. PLoS Med. 2008, 5 (7): e148-10.1371/journal.pmed.0050148.CrossRefPubMedPubMedCentral
35.
Egger M, May M, Chene G, Phillips AN, Ledergerber B, Dabis F, Costagliola D, D'Arminio Monforte A, de Wolf F, Reiss P, Lundgren JD, Justice AC, Staszewski S, Leport C, Hogg RS, Sabin CA, Gill MJ, Salzberger B, Sterne JA: Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies. Lancet. 2002, 360: 119-129. 10.1016/S0140-6736(02)09411-4.CrossRefPubMed
36.
Coetzee D, Hildebrand K, Boulle A, Maartens G, Louis F, Labatala V, Reuter H, Ntwana N, Goemaere E: Outcomes after two years of providing antiretroviral treatment in Khayelitsha, South Africa. AIDS. 2004, 18: 887-895. 10.1097/00002030-200404090-00006.CrossRefPubMed
37.
Celum C, Levine R, Weaver M, Wald A: Genital herpes and human immunodeficiency virus: double trouble. Bull World Health Organ. 2004, 82: 447-453.PubMedPubMedCentral
38.
Manigart O, Courgnaud V, Sanou O, Valea D, Nagot N, Meda N, Delaporte E, Peeters M, Van de Perre P: HIV-1 superinfections in a cohort of commercial sex workers in Burkina Faso as assessed by an autologous heteroduplex mobility procedure. AIDS. 2004, 18: 1645-1651. 10.1097/01.aids.0000131333.30548.db.CrossRefPubMed
39.
Hoffmann CJ, Fielding KL, Charalambous S, Sulkowski MS, Innes C, Thio CL, Chaisson RE, Churchyard GJ, Grant AD: Antiretroviral therapy using zidovudine, lamivudine, and efavirenz in South Africa: tolerability and clinical events. AIDS. 2008, 22: 67-74. 10.1097/QAD.0b013e3282f2306e.CrossRefPubMedPubMedCentral
40.
Hamers RL, Derdelinckx I, van Vugt M, Stevens W, Rinke de Wit TF, Schuurman R: The status of HIV-1 resistance to antiretroviral drugs in sub-Saharan Africa. Antivir Ther. 2008, 13: 625-639.PubMed
41.
Tebit DM, Sangare L, Makamtse A, Yameogo S, Somlare H, Bado G, Kouldiaty BG, Sathiandee K, Tiba F, Sanou I, Ouedraogo-Traore R, Zoungrana L, Diallo I, Drabo JY, Krausslich HG: HIV drug resistance pattern among HAART-exposed patients with suboptimal virological response in Ouagadougou, Burkina Faso. J Acquir Immune Defic Syndr. 2008, 49: 17-25. 10.1097/QAI.0b013e318182d2bc.CrossRefPubMed
42.
Goldie SJ, Yazdanpanah Y, Losina E, Weinstein MC, Anglaret X, Walensky RP, Hsu HE, Kimmel A, Holmes C, Kaplan JE, Freedberg KA: Cost-effectiveness of HIV treatment in resource-poor settings--the case of Cote d'Ivoire. N Engl J Med. 2006, 355 (11): 1141-1153. 10.1056/NEJMsa060247.CrossRefPubMed
Metadata
Title
Long term virological, immunological and mortality outcomes in a cohort of HIV-infected female sex workers treated with highly active antiretroviral therapy in Africa
Authors
Charlotte Huet
Abdoulaye Ouedraogo
Issouf Konaté
Isidore Traore
François Rouet
Antoinette Kaboré
Anselme Sanon
Philippe Mayaud
Philippe Van de Perre
Nicolas Nagot
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-700

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue

Research article

Is there an impact of public smoking bans on self-reported smoking status and exposure to secondhand smoke?

Research article

Weight gain and incident obesity among male snus users

Study protocol

The ACCOMPLISH study. A cluster randomised trial on the cost-effectiveness of a multicomponent intervention to improve hand hygiene compliance and reduce healthcare associated infections

Research article

Drinking behaviours and blood alcohol concentration in four European drinking environments: a cross-sectional study

Research article

HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa

Study protocol

Hands4U: A multifaceted strategy to implement guideline-based recommendations to prevent hand eczema in health care workers: design of a randomised controlled trial and (cost) effectiveness evaluation