[Antiretroviral therapy with three nucleoside reverse transcriptase inhibitors in treatment-naive HIV-infected patients in Abidjan (Cote d'Ivoire)]. / Le traitement antirétroviral à base de trois inhibiteurs nucléosidiques de la transcriptase inverse chez les patients naïfs infectés par le VIH à Abidjan (Côte d'Ivoire).

This study assesses the results of initial antiretroviral therapy with 3 nucleoside reverse transcriptase inhibitors over the first 12 months of treatment. Patients' general health improved significantly during the year, with a significant mean weight gain (from 59.3 kg to 65.12 kg) and a strong regression in the frequency of opportunistic infections over the study period, from 38% to 2% (P<0.0001). The mean CD4 T-cell count rose from 242.8 to 390.5 cell/mm(3), for a mean increase of 147.7 cells/mm(3). Accordingly, antiretroviral treatment with three nucleoside reverse transcriptase inhibitors is effective and is a useful alternative in a country with limited resources.

[Human rabies in Abidjan (Côte d'Ivoire): recent cases]. / Rage humaine à Abidjan (Côte d'Ivoire): nouvelles observations.

OBJECTIVE: To present epidemiological and clinical aspects of human rabies in a hospital center. METHOD: We analyzed medical records of cases of rabies in humans treated at the infectious disease department of the Treichville University Hospital Center from January 2005 through December 2009. RESULTS: Seven cases of human rabies were reported during those five years, four in teenagers and three in adults. Five of the cases involved bites by stray dogs whose vaccine status was unknown. No patient had had a pre-exposure prophylactic vaccination, and only four post-exposure prophylaxis, all incomplete. All of the patients developed furious rabies and fever 21 to 96 days (mean: 47.7) after the dog bite, when the wounds had healed and scars formed. Death occurred 4 to 10 days after the onset of symptoms (mean: 4.7). Relatives refused autopsies in all cases. CONCLUSION: It is indispensable to increase population awareness of prevention by vaccination against human rabies, reduce the population of stray dogs, and promote mass vaccination of dogs in the Ivory Coast.

Cryptoccocal meningitis and HIV in the era of HAART in Côte d'Ivoire.

OBJECTIVE: The authors had for aim to describe the management of cryptococcal meningitis in HIV infected adults, in Ivory Coast. PATIENTS AND METHODS: A retrospective study was made from January 1, 2005 to December 31, 2008 on the files of consecutive hospitalized patients presenting with cryptococcal meningitis, at the Treichville University Hospital, Infectious and tropical diseases department (Abidjan). The socio-demographic, clinical, and biological aspects as well as the outcome were analyzed. RESULTS: Eighty patients presenting with cryptococcal meningitis, (2.6% of hospitalized patients) were included: 41 men (51.25%) and 39 women (48.75%); mean age: 40 years (range 26 to 58 years). The delay before consultation was 5.4 days, range 2-12 days). The mains symptoms were headache (83.7%), fever (63.7%), and consciousness disorders (60%). Meningo-encephalitis accounted for 75% of the clinical presentations; 54 patients (67.5%) were naive of antiretroviral treatment (mean CD4: 45/mm(3) (range 5-103/mm(3)), while 26 (32.5%) had received antiretrovirals before presenting with cryptococcal meningitis (Nadir CD4=81/mm(3)). Amphotericin B relayed by fluconazole was prescribed to 86.2% of the patients, associated with a therapeutic lumbar puncture for 30 patients. The death rate was 41.2%. CONCLUSION: In spite of antiretroviral treatment availability in Ivory Coast, cryptococcal meningitis remains frequent with a high death rate. This study stresses the importance of early management to improve the prognosis.