1 / 15

Background (1)

" Susceptibility to transmitting HIV in ART-treated individuals: Longitudinal analysis from Stratall ANRS 12110/ESTHER trial.".

artie
Download Presentation

Background (1)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. "Susceptibility to transmitting HIV in ART-treated individuals: Longitudinal analysis from Stratall ANRS 12110/ESTHER trial." Julien Cohen1,2,3, Sylvie BOYER1,2,3, Charles Kouanfack4, Maria Patrizia Carrieri1,2,3, Gilbert Ndziessi1,2,3, Camélia PROTOPOPESCU1,2,3, Jean-Paul MOATTI1,2,3, Eric Delaporte5,6, Christian LAURENT5,6, Bruno Spire1,2,3 and the Stratall ANRS 12110/ESTHER Study Group 1 INSERM, U912 (SE4S), Marseille, France 2 Université Aix Marseille, IRD, UMR-S912, Marseille, France 3 ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d’Azur, Marseille, France 4 Central Hospital, Yaoundé, Cameroon 5 Institut de Recherche pour le Développement (IRD), University Montpellier 1, UMR 145, Montpellier, France 6 Department of Infectious and Tropical Diseases, University Hospital, Montpellier, France

  2. Background (1) ART preventive intervention for reducing sexual HIV transmission: • High efficacy of antiretroviral therapy for vertical transmission • A 92% reduction in transmission among 3381 ART-treated heterosexual African couples Donnel, 2010 • HPTN 052 trial: Immediate ART initiation reduced HIV-infection in sexual partners by 96% compared with ART initiation following WHO guidelines.

  3. Background (2) Reduction of HIV transmission by ART Behavioral disinhibition concerning condom use? Longitudinal data from the ANRS STRATALL studywere used to explore : • the course of sexual risk of HIV-transmission during the first 24 months of treatment in ART naïve HIV-infected adults • the characteristics of viremic ART-treated PLWHA who do not consistently use condoms

  4. Methods (1) Stratall ANRS 12110/ESTHER : • 24-month, randomized, open-label trial • Enrolled 459 HIV-infected adults followed-up in rural district hospitals in Cameroon • Primary objective : to compare the increase in CD4 cell counts in two groups using: • Eitherthe recommended WHO “public health” approach for low-income countries • Or the standard approach used in developed countries

  5. Methods (2) • Plasma viral load measured during clinical visits at M0, M6, M12, M18 and M24. • Psychosocial data (including sexual behaviors and healthcare staff’s readiness to listen) collected using face-to-face questionnaires administered at M0, M6, M12 and M24

  6. Methods (4) • Stable virological success (SVS) : having an undetectable viral load (<40 copies/ml) for more than 6 months. • Inconsistent condom use (ICU): Not using condoms with HIV-negative partners or those with unknown serostatus at least once in the three months prior to the visit • Susceptibility to transmitting HIV was defined as: lack of SVS + ICU

  7. Methods (5) • McNemar tests were performed to assess changes in ICU and susceptibility to transmitting HIV during follow-up • A mixed logistic regression model was used to identify correlates of susceptibility to transmitting HIV

  8. Results (1) Proportion of patients with detectable viral load among patients sexually active during follow-up (n=290)

  9. Results (2) Proportion of ICU among patients sexually active during follow-up (n=290)

  10. Results (3) Proportion of patients susceptible to transmitting HIV among those sexually active during follow-up (n=290)

  11. Results (4) Factors associated with susceptibility to transmittingHIV (Mixed logistic regression, N=290 patients, 593 visits)

  12. Conclusion • Despite an increase in ICU, the proportion of individuals susceptible to transmitting HIV decreased and remained low. • Fear of behavioral disinhibition should not be a barrier to universal access to treatment. • Reinforcing healthcare staff’s counseling skills may be crucial for positive prevention.

  13. Acknowledgments Participating patients & hospital teams Sponsorship: - French National Agency for Research on AIDS and viral hepatitis (ANRS) • French Public Interest Group ESTHER • SIDACTION The Stratall ANRS 12110/ESTHER trial Study Group C. Kouanfack, S. Koulla-Shiro (Central hospital, Yaoundé, Cameroon); A. Bourgeois, E. Delaporte, C. Laurent (IRD, University Montpellier 1, UMR 145, Montpellier, France); G. Laborde-Balen (French Ministry of Foreign Affairs, Yaoundé, Cameroon); T. AtemkengFotsop, M. Dontsop, S. Kazé, J-M. Mben, M-A. Ngo Hamga, Z. Tsomo (IRD, Yaoundé, Cameroon); A. Aghokeng, M.G. Edoul, E. Mpoudi-Ngolé, M. Tongo (Virology Laboratory, IMPM/CREMER/IRD-UMR 145, Yaoundé, Cameroon); J. Blanche, S. Boyer, M.P. Carrieri, J. Cohen, S. Loubière, M. Meresse, F. Marcellin, J-P. Moatti, B. Spire (INSERM, IRD, University Aix Marseille, UMR 912, Marseille, France); C. Abé, S-C. Abega, C-R. Bonono, H. Mimcheu, S. Ngo Yebga, C. Paul Bile (IRSA, Catholic University of Central Africa, Yaoundé, Cameroon); S. Abada, T. Abanda, J. Baga, P. BilobiFouda, P. EtongMve, G. Fetse Tama, H. Kemo, A. Ongodo, V. Tadewa, HD. Voundi (District Hospital, Ayos, Cameroon); A. Ambani, M. Atangana, J-C. Biaback, M. Kennedy, H. Kibedou, F. Kounga, M. MaguipAbanda, E. Mamang, A. Mikone, S. Tang, E. Tchuangue, S. Tchuenko, D. Yakan (District Hospital, Bafia, Cameroon); J. Assandje, S. Ebana, D. Ebo’o, D. Etoundi, G. Ngama, P. MbargaAngo, J. Mbezele, G. Mbong, C. Moung, N. Ekotto, G. NguembaBalla, G. Ottou, M. Tigougmo (District Hospital, Mbalmayo, Cameroon); R. Beyala, B. Ebene, C. Effemba, F. Eyebe, M-M. Hadjaratou, T. Mbarga, M. Metou, M. Ndam, B. Ngoa, EB. Ngock, N. Obam (District hospital, Mfou, Cameroon); A. M. Abomo, G. Angoula, E. Ekassi, Essama, J.J. Lentchou, I. Mvilongo, J. Ngapou, F. Ntokombo, V. Ondoua, R. Palawo, S. Sebe, E. Sinou, D. Wankam, I. Zobo (District hospital, Monatélé, Cameroon); B. Akono, A. L. Ambani, L. Bilock, R. Bilo’o, J. Boombhi, F.X. Fouda, M. Guitonga, R. Mad’aa, D.R. Metou’ou, S. Mgbih, A. Noah, M. Tadena, Ntcham (District hospital, Nanga Eboko, Cameroon); G. AmbassaElime, A.A. Bonongnaba, E. Foaleng, R.M. Heles, R. Messina, O. Nana Ndankou, S.A. Ngono, D. NgonoMenounga, S.S. Sil, L. Tchouamou, B. Zambou (District hospital, Ndikinimeki, Cameroon); R. Abomo, J. Ambomo, C. Beyomo, P. Eloundou, C. Ewole, J. Fokom, M. Mvoto, M. Ngadena, R. Nyolo, C. Onana, A. Oyie (District hospital, Obala, Cameroon); P. Antyimi, S. Bella Mbatonga, M. Bikomo, Y. MoloBodo, S. NdiNtang, P. Ndoudoumou, L. Ndzomo, S.O. Ngolo, M. Nkengue, Nkoa, Y. Tchinda (District hospital, Sa’a, Cameroon).

  14. THE ITALIAN GOVERNMENT STILL OWES 260 MILLION EUROS TO THE GLOBAL FUND AND NEVER PLEDGED FOR 2011 - 2013 ITALY:KEEP THE PROMISE, NOW!FUND THE FUND, NOW! AIDS, TUBERCOLOSIS AND MALARIA WILL NOT WAIT!

More Related