Abstract

Danho Pascal Abrogoua *, Brou Jérôme Kablan , Gilles Aulagner and Claude Petit

The search for determinants responsible for changes in CD4 cells count can help to optimize the efficiency of the nevirapine-based antiretroviral therapy in Côte d'Ivoire. Our study on the response to this treatment was carried out through taxonomy of CD4 cells count trajectories using non-hierarchical-descendant model. One hundred and sixty four patients were grouped according to their baseline CD4 count in three strata (200/mm3 ). In each category, classes of similar CD4 count trajectories represented by standard paths called meta-trajectories have been formed by the model and we have searched for the determining factors. On the overall, there was a significant variation between classes (p<0.001) of the following variables: average CD4 count, nadir CD4, peak CD4, average CD4 gain. According to the profile of metatrajectories, CD4 cells gains are obvious during the first six months of treatment, and then changes are variable according to classes regardless of the baseline CD4 count. The other medical follow -up variables showed no significant variation between classes in the categories of initial CD4 count 100/mm3 . However in patients with baseline CD4<100/mm3 , variables like mean weight (p=0.04), mean hemoglobin count (p=0.01) and average gain of hemoglobin (p=0.03) are also explanatory of partition into different classes. Baseline characteristics showed no significant variation between the different classes in the categories of initial CD4 count 100/mm3 . However for patients with baseline CD4 count<100/mm3 , sex is explanatory of classes partition (p<0.05) . Correspondence analysis revealed other determining factors related to the different meta-trajectories (initial CD4 count, initial CD4 cells percentage, adherence, presence, or absence of opportunistic infections prior to the treatment). These factors influencing the CD4 cells response of nevirapine-based regimen in Côte d'Ivoire must be considered to maximize efficiency of the treatment.