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Anthropometric and Immunological Sucess of Antiretroviral Therapy and Prediction of Virological Success in West African Adults

Objective:The 6 month assessment of the response to antiretroviral therapy (ART) is a critical step. In sub-Saharan Africa, few people have access to plasma viral-load measurement. The gain or loss in body mass index (BMI) was assessed alone or in combination with corresponding gain in CD4 cells as a tool for predicting the response to ART. Methods: In a cohort of 622 adults in Abidjan, Côte d’Ivoire, we calculated the sensitivity, specificity and predictive values of BMI and CD4 for treatment success defined as viral-load undetectability (< 300 copies/ml) as gold standard. Conclusion In settings where viral-load measurement is not available, a high BMI gain does not reflect virological success, even when combined with a high CD4 gain. In our population, most patients with detectable viral-load had probably adhered to the drug regimen sufficiently to reach significant gains in body mass and CD4 count but had adhered insufficiently to reach viral suppression.