title: Clinical and biological evolution of HIV-1 seroconverters in Abidjan, Côte d'Ivoire, 1997-2000.
abstract: OBJECTIVE
  To describe the clinical and biologic evolution of HIV-1 infection in Africa.
  
  
  METHODS
  One hundred four HIV-1-infected individuals were identified prospectively from regular blood donors in Abidjan, Côte d'Ivoire. The date of seroconversion was estimated from results of sequential serologic tests. Biologic and clinical follow-up was performed every 6 months, starting as early as possible after seroconversion. Case management followed national guidelines.
  
  
  RESULTS
  The median interval between estimated seroconversion and study inclusion was 9.7 months, and the median window of seroconversion was 2.8 months. At baseline, all but two patients were asymptomatic; the median CD4 + cell count was 527/mm 3 (interquartile range [IR], 395-684), and the median plasma HIV RNA level was 4.6 log 10 copies/ml (IR, 3.8-4.9). The median follow-up was 23.9 months, and 95% of the patients received primary prophylaxis with co-trimoxazole for opportunistic infections. Of the patients, 1 presented with wasting syndrome, 3 developed tuberculosis, and 17 had a Centers for Disease Control and Prevention category B-defining event. The 3-year AIDS-free and symptom-free probabilities were 96.7% (95% confidence interval [CI], 87.0-99.2] and 79.3% (95% CI, 67.5-87.2), respectively. During the first 3 years of follow-up, we observed that the median plasma viral load stabilized at >4 log 10 copies/ml and that the median CD4 + cell count declined by 20 to 25/mm 3 per year.
  
  
  CONCLUSIONS
  These African seroconverters were moderately immunosuppressed. The median HIV RNA level was high and varied very little during the first 3 years, and there were few clinical events.
authors.affiliation: Unité INSERM 330, ISPED, Université Victor Segalen Bordeaux 2, Bordeaux, France. roger.salamon@isped.u-bordeaux2.fr
authors.forename: Roger
authors.initials: R
authors.lastname: Salamon
authors.forename: Catherine
authors.initials: C
authors.lastname: Marimoutou
authors.forename: Daniel
authors.initials: D
authors.lastname: Ekra
authors.forename: Albert
authors.initials: A
authors.lastname: Minga
authors.forename: Eric
authors.initials: E
authors.lastname: Nerrienet
authors.forename: Catherine
authors.initials: C
authors.lastname: Huët
authors.forename: Gwenola
authors.initials: G
authors.lastname: Gourvellec
authors.forename: Dominique
authors.initials: D
authors.lastname: Bonard
authors.forename: Issouf
authors.initials: I
authors.lastname: Coulibaly
authors.forename: Patrice
authors.initials: P
authors.lastname: Combe
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.forename: Alain
authors.initials: A
authors.lastname: Bondurand
authors.forename: Luc
authors.initials: L
authors.lastname: Montagnier
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D007560:Cote d'Ivoire; D019143:Evolution, Molecular; D005260:Female; D005500:Follow-Up Studies; D015752:Genes, env; D016333:HIV Protease / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000235:genetics; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000150:complications; D019562:Viral Load
chemical_list: D012367:RNA, Viral; D054303:HIV Reverse Transcriptase; D016333:HIV Protease