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[Comparative study of two anti-antiretroviral protocols used for treatment of a cohort of HIV 1-positive patients followed at the Institute of Public Health and Hygiene in Dakar, Senegal].

In the last ten years, the discovery of several antiretroviral drugs has greatly contributed to improving the survival and quality of life of HIV-infected persons. The purpose of this retrospective study was to compare the effectiveness and tolerance of two anti-retroviral combinations, i.e., Lamivudine + Zidovudine and Efavirenz versus Lamivudine + Zidovudine and Nevirapine. The files of HIV1-infected patients treated between July 2003 and December 2004 (18 months) and followed at the Institute of public health and hygiene in Dakar were reviewed. A total of 70 patients, i.e., 35 in each protocol group, were included. The following data were collected for each patient: age, sex, locality, elements to assess tolerance, and elements to assess effectiveness (CD4 count, viral load and opportunistic infection immuno-failure). Results indicated that the immunovirologic effectiveness of the two protocols was identical with regard to mean CD4 count, i.e., 327 cells/mm3 for AZT+3TC+EFV versus 334 cells/mm3 for AZT+ 3TC+NVP (p < 0.05). Immuno effectiveness was better for Lamivudine + Zidovudine + Efavirenz than Lamivudine + Zidovudine + Nevirapine. Significant therapeutic advances in recent years have improved survival and quality of life in patients under retroviral treatment. There are currently many anti-retroviral molecules available and several relatively well codified therapeutic protocols.