Clinical and biological evolution of HIV-1 seroconverters in Abidjan, Côte d'Ivoire, 1997-2000.
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.
Salamon
Roger
R
Unité INSERM 330, ISPED, Université Victor Segalen Bordeaux 2, Bordeaux, France. roger.salamon@isped.u-bordeaux2.fr
Marimoutou
Catherine
C
Ekra
Daniel
D
Minga
Albert
A
Nerrienet
Eric
E
Huët
Catherine
C
Gourvellec
Gwenola
G
Bonard
Dominique
D
Coulibaly
Issouf
I
Combe
Patrice
P
Dabis
François
F
Bondurand
Alain
A
Montagnier
Luc
L
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
D012367:RNA, Viral; D054303:HIV Reverse Transcriptase; D016333:HIV Protease