Diagnosis of acute infection of HIV in health facilities of Bamako

Abstract

Introduction

The diagnosis of acute infection remains insufficiently discussed due to the limited means in the context of resource-limited countries. This work aims to identify cases of acute HIV infection in Bamako.

Method

It is a prospective cross-sectional and descriptive study carried out among the all-vets in consultation in 12 health facilities and counseling and voluntary testing center of Bamako.

The diagnostic process consisted of using a clinical approach with counseling to obtain symptoms and risk behaviors combined to a biological approach to performing HIV tests. The biological markers and the determination of the stages of acute infection have been made as described by Fiebig et al.

Results

Of the 29130 subjects screened in the 12 sites, 19 had acute infection with associated hematologic abnormalities (thrombocytopenia, lymphopenia or neutropenia). The median of viral load was 58,108 copies/ml (4.8Log10), the median of CD4 was 339 cells/mm³ and the median of CD8 was 772 cells/mm³. The acute stages of HIV were: stage 1 (5 cases), stage II (1 case), stage III (6 cases) and stage IV (7 cases). The most common exposure factor was unprotected sex found in 14 cases.

Conclusion

In the screening strategies, special emphasis should be placed on identifying acute infections with enhanced counseling in groups at high risk of exposure.