Abstracts
Résumé
Les connaissances utiles à la lutte contre le virus de l’immunidéficience humaine (VIH) et le sida en Afrique subsaharienne ne sont pas toutes extrapolables à partir des données issues des pays industrialisés. Cet article tente de passer en revue les spécificités de l’épidémie africaine en termes d’épidémiologie, d’histoire naturelle, d’interventions thérapeutiques validées et de questions restant à explorer. Loin d’être démunis d’outils efficaces et de pistes de recherches pour lutter contre ce fléau qui décime un continent, nous sommes aujourd’hui avant tout confrontés à un déficit de mobilisation et de moyens.
Summary
Knowledge useful to the fight against HIV/AIDS in sub-Saharan Africa cannot be extrapolated to those coming from industrialized countries. The aim of this article is to review specificities of the African epidemy, in terms of epidiomolgy, natural history, validated therapeutic interventions, and unexplored questions. Far from being without effective tools and research tracks to fight against this plague which decimates a continent, one is above all confronted with a deficit of both mobilization and means.
Appendices
Références
- 1. Onusida. Mise à jour des données épidémiologiques sur le VIH, décembre 2002, 38 pages. http://www.unaids.org/worldaidsday/2002/press/update/ epiupdate2002_fr.doc
- 2. Onusida. Survol de l’épidémie dans le monde. Rapport sur l’épidémie mondiale de VIH/sida 2002, chapitre 2 : 21-42.
- 3. Onusida. Rapport sur l’épidémie mondiale de VIH/sida 2002. 214 pages. http:// www.unaids.org/barcelona/presskit/french/barcelona report/contents_html.html
- 4. Buvé A, Bishikwabo-Nsarhaza K, Mutangadura G. The spread and effect of HIV-1 infection in sub-Saharan Africa. Lancet 2002 ; 359 : 2001-17.
- 5. Zhu T, Korber B, Nahmias A, et al. An African HIV-1 sequence from 1959 and implications for the origin of the epidemic. Nature 1998 ; 391 : 594-7.
- 6. Korber B, Muldoon M, Theiler J, et al. Timing the ancestor of the HIV-1 pandemic strains. Science 2000 ; 288 : 1789-96.
- 7. Quinn T. Global burden of the HIV pandemic. Lancet 1996 ; 348 : 99-106.
- 8. Peeters M, Sharp P. Genetic diversity of HIV-1 : The moving target. AIDS 2000 ; 14 : 129-40.
- 9. Buvé A, Caraël M, Hayes R, et al. The multicentre study on factors determining the differential spread of HIV in four African cities : Summary and conclusions. AIDS 2001 ; 15 : 127-31.
- 10. Banque mondiale. Rapport sur le développement dans le monde 1993 : investir dans la santé. Paris, 1993, 340 p.
- 11. Djomand G, Greenberg AE, Sassan-Morokro M, et al. The epidemic of HIV/AIDS in Abidjan, Côte d’Ivoire : A review of data collected by projet RETRO-CI from 1987 to 1993. J Acquir Immune Def Syndr Hum Retrovir 1995 ; 10 : 358-65.
- 12. Anglaret X, Gnangbomon J, Coulibaly-Koné S, et al. Clinical and immunological stages of HIV-infected patients attending community clinics, Abidjan, Côte d’Ivoire. Int J STD AIDS 1998 ; 9 : 432-3.
- 13. Grant A, Djomand G, Smets P, et al. Profound immunosuppression across the spectrum of opportunistic disease among hospitalized HIV-infected adults in Abidjan, Côte d’Ivoire. AIDS 1997 ; 11 : 1357-64.
- 14. Kamanfu G, Mlika-Cabanne N, Girard P, et al. Pulmonary complications of human immunodeficiency virus infection in Bujumbura, Burundi. Am Rev Respir Dis 1993 ; 147 : 658-63.
- 15. Brindle RJ, Nunn PP, Batchelor BI, et al. Infection and morbidity in patients with tuberculosis in Nairobi, Kenya. AIDS 1993 ; 7 : 1469-74.
- 16. Clerinx J, Bogaerts J, Taelman H, et al. Chronic diarrhoea among adults in Kigali, Rwanda : association with bacterial enteropathogens, rectocolonic inflammation, and human immunodeficiency virus infection. Clin Infect Dis 1995 ; 21 : 1282-4.
- 17. Malin A, Gwanzura L, Klein S, et al. Pneumocystis carinii pneumonia in Zimbabwe. Lancet 1995 ; 346 : 1258-61.
- 18. Daley C, Mugusi F, Chen L, et al. Pulmonary complications of HIV infection in Dar es Salaam, Tanzania. Role of bronchoscopy and bronchoalveolar lavage. Am J Respir Crit Care Med 1996 ; 154 : 105-10.
- 19. Jones N, Huebner R, Khoosal M, et al. The impact of HIV on Streptococcus pneumoniae bacteraemia in a South African population. AIDS 1998 ; 12 : 2177-84.
- 20. Archibald L, McDonald L, Nwanyanwu O, et al. A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi : implications for diagnosis and therapy. J Infect Dis 2000 ; 181 : 1414-20.
- 21. Batungwanayo J, Taelman H, Allen S, et al. Pleural effusion, tuberculosis and HIV-1 infection in Kigali, Rwanda. AIDS 1993 ; 7 : 73-9.
- 22. Batungwanayo J, Taelman H, Lucas S, et al. Pulmonary disease associated with the human immunodeficiency virus in Kigali, Rwanda : a fibre optic bronchoscopic study of 111 cases of undetermined etiology. Am J Respir Crit Care Med 1994 ; 6 : 1591-6.
- 23. Gilks C, Brindle R, Otieno L, et al. Life-threatening bacteraemia in HIV-1 seropositive adults admitted to hospital in Nairobi, Kenya. Lancet 1990 ; 346 : 545-9.
- 24. Scott J, Hall A, Muyodi C, et al. Aetiology, outcome, and risk factors for mortality among adults with acute pneumonia in Kenya. Lancet 2000 ; 355 : 1225-30.
- 25. Vugia DJ, Kiehlbauch JA, Yeboue K, et al. Pathogens and predictors of fatal septicemia associated with the human immunodeficiency virus infection in Ivory Coast, West Africa. J Infect Dis 1993 ; 168 : 564-70.
- 26. Mwachari C, Batchelor B, Paul J, et al. Chronic diarrhoea among HIV-infected adult patients in Nairobi, Kenya. J Infect 1998 ; 37 : 48-53.
- 27. Germani Y, Minssart P, Vohito M, et al. Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African republic, in relation to human immunodeficiency virus serostatus. Am J Trop Med Hyg 1998 ; 59 : 1008-14.
- 28. Lucas SB, Hounnou A, Peacock C, et al. The mortality and pathology of HIV infection in a West African city. AIDS 1993 ; 7 : 1569-79.
- 29. Leroy V, Msellati P, Lepage P, et al. Natural history of HIV-1 infection in African women : a prospective cohort study in Kigali, Rwanda, 1988-1993. J Acquir Immune Def Syndr 1995 ; 9 : 415-21.
- 30. Gilks C, Ojoo S, Brindle R, et al. Invasive pneumococcal disease in a cohort of predominantly HIV-1 infected female sex-workers in Nairobi, Kenya. Lancet 1996 ; 347 : 718-23.
- 31. French N, Nakiyingi J, Carpenter L, et al. 23-valent pneumococcal polysaccharide vaccine in HIV-1-infected Ugandan adults : double-blind, randomised and placebo controlled trial. Lancet 2000 ; 355 : 2106-11.
- 32. Perriëns JH, St Louis ME, Mukadi YB, et al. Pulmonary tuberculosis in HIV-infected patients in Zaïre. A controlled trial of treatment for either 6 or 12 months. N Engl J Med 1995 ; 332 : 779-84.
- 33. Allen S, Batungwanayo J, Kerlikowske K, et al. Two-year incidence of tuberculosis in cohorts of HIV-infected and uninfected urban Rwandan women. Am J Med 1992 ; 146 : 1439-44.
- 34. Ackah AN, Coulibaly D, Digbeu H, et al. Response to treatment, mortality, and CD4 lymphocytes counts in HIV-infected persons with tuberculosis in Abidjan, Côte d’Ivoire. Lancet 1995 ; 345 : 607-10.
- 35. Morgan D, Maude G, Malambra S, et al. HIV-1 disease progression and AIDS-defining disorders in rural Uganda. Lancet 1997 ; 350 : 245-50.
- 36. Sewankambo N, Gray R, Ahmad S, et al. Mortality associated with HIV infection in rural Rakai District, Uganda. AIDS 2000 ; 14 : 2391-400.
- 37. French N, Mujugira A, Nakiyingi J, et al. Immunologic and clinical stages in HIV-1-infected Ugandan adults are comparable and provide no evidence of rapid progression but poor survival with advanced disease. J Acquir Immune Def Syndr 1999 ; 22 : 509-16.
- 38. Malamba S, Morgan D, Clayton T, et al. The prognostic value of the World health organisation staging system for HIV infection and disease in rural Uganda. AIDS 1999 ; 13 : 2555-62.
- 39. Whitworth J, Morgan D, Quigley M, et al. Effect of HIV-1 and increasing immunosppression on malaria parasitemia and clinical episodes in adults in rural Uganda. Lancet 2000 ; 356 : 1051-6.
- 40. Anglaret X, Chene G, Attia A, et al. Early chemoprophylaxis with trimetoprim-sulphamethoxazole for HIV-1 infected adults in Abidjan, Côte d’Ivoire : a randomised trial. Lancet 1999 ; 353 : 1462-8.
- 41. Anglaret X, Messou E, Ouassa T, et al. Pattern of bacterial diseases in a cohort of HIV-1 infected adults receiving cotrimoxazole prophylaxis, Abidjan, Côte d’Ivoire. AIDS 2003 ; 17 : 575-84.
- 42. De Cock K, Chaisson R. Will DOTS do it ? A reappraisal of tuberculosis control in countries with high rates of HIV infection. Int J Tuberc Lung Dis 1999 ; 3 : 457-65.
- 43. Whalen C, Jonhson J, Okwera A, et al. A trial of three regimens to prevent tuberculosis in Ugandan adults infected with the human immunodeficiency virus. N Engl J Med 1997 ; 337 : 801-8.
- 44. Unaids/WHO. Preventive therapy against tuberculosis in people living with HIV. Wkly Epidemiol Rec 1999 ; 74 : 385-400.
- 45. Quigley M, Mwinga A, Hosp M, et al. Long-term effect of preventive therapy for tuberculosis in a cohort of HIV-infected Zambian adults. AIDS 2001 ; 15 : 215-22.
- 46. Fitzgerald D, Desvarieux M, Severe P, et al. Effect of post-treatment isoniazid on prevention of recurrent tuberculosis in HIV-1-infected individuals : a randomised trial. Lancet 2000 ; 356 : 1470-4.
- 47. Wiktor S, Sassan-Morokro M, Grant A, et al. Efficacy of trimethoprim-sulphamethoxazole prophylaxis to decrease morbidity and mortality in HIV-1-infected patients with tuberculosis in Abidjan, Côte d’Ivoire : a randomised controlled trial. Lancet 1999 ; 353 : 1469-75.
- 48. Unaids/WHO. Provisional WHO/Unaids secretariat recommendations on the use of cotrimoxazole prophylaxis in adults and children living with HIV/AIDS in Africa. 2000 : http://www.unaids.org/publications/documents/care/general/recommendation-eng.pdf
- 49. Anglaret X, Dabis F, Batungwanayo J, et al. Chimioprophylaxie primaire de la tuberculose chez les séropositifs dans les pays non industrialisés. Santé 1997 ; 7 : 89-94.
- 50. Boeree M, Harries A, Zijlstra E, et al. Co-trimoxazole in HIV-1 infection. Lancet 1999 ; 354 : 334.
- 51. Iyer J, Milhous W, Cortese J, et al. Plasmodium falciparum cross-resistance between trimethoprim and pyrimethamine. Lancet 2001 ; 358 : 1066-7.
- 52. Martin J, Rose D, Hadley W, et al. Emergence of trimethoprim-sulfamethoxazole resistance in the AIDS era. J Infect Dis 1999 ; 180 : 1809-18.
- 53. Anglaret X. Cotrimoxazole prophylaxis in sub-Saharan Africa. Lancet 2001 ; 358 : 1027-8.
- 54. Weidle P, Malamba S, Mwebaze R, et al. Assessment of a pilot antiretroviral drug therapy programme in Uganda : patients’ response, survival, and drug resistance. Lancet 2002 ; 360 : 34-40.
- 55. Laurent C, Diakhate N, Gueye N, et al. The Senegalese government’s highly active antiretroviral therapy initiative : an 18-month follow-up study. AIDS 2002 ; 16 : 1363-70.
- 56. Seyler C, Anglaret X, Dakoury-Dogbo N, et al. Medium-term survival, morbidity, and immuno-virological evolution in HIV-infected adults receiving antiretroviral therapy, Abidjan, Côte d’Ivoire. Antivir Ther 2003 ; 8 : 385-93.
- 57. Race E, Adelson-Mitty J, Kriegel G, et al. Focal mycobacterial lymphadenitis following initiation of protease-inhibitor therapy in patients with advanced HIV-1 disease. Lancet 1998 ; 351 : 252-5.
- 58. French M, Lenzo N, John M, et al. Immune restoration disease after the treatment of immunodeficient HIV-infected patients with highly active antiretroviral therapy. HIV Med 2000 ; 1 : 107-15.
- 59. Heath K, Singer J, O’Shaughnessy M, et al. Intentional nonadherence due to adverse symptoms associated with antiretroviral therapy. J Acquir Immune Def Syndr 2002 ; 31 : 211-7.