Browsing by Autor "Bernard Taverne"

Now showing 1 - 5 of 5

Évaluation du coût direct de la prise en charge médicale du VIH entre la troisième et la dixième année de traitement ARV à Dakar
(Springer Science+Business Media, 2014) Sabah Boufkhed; Bernard Taverne
The direct cost of medical care for HIV infection-excluding ARVs, viral load and CD4 counts-was assessed for patients who received ARV treatment in Senegal within the framework of the ANRS cohort 1215, between the third and tenth year of follow-up. The average annual direct cost was estimated at 120 <euro>/patient/year; this amount remained stable over the first ten years of treatment follow-up. Biological assessments for routine follow-up account for the majority of these costs (66%), followed by drugs (26%). Given the level of economic poverty facing by families, patients cannot bear such expenses over several years. However, these costs appear low enough to be covered by HIV-treatment programs or included in Universal Health Coverage systems.
Impact à long terme des traitements antirétroviraux en Afrique, état des connaissances
(Springer Science+Business Media, 2014) Bernard Taverne; Alice Desclaux; Éric Delaporte; Ibra Ndoye
By the end of 2013, 11 million PLHIV were taking ARVs in Africa; application of the WHO recommendation to initiate treatment earlier (at CD4 count of 500 cells/mm3 or less) should further increase this number. Currently, twothirds of patients in Africa have been on treatment for less than five years, and less than 10% have received treatment for eight years or more. Given the historical perspective is in its early stages, the long-term impact of ARV therapy is still unclear. This article reviews the knowledge gained over the period marking the first ten years of implementation of the universal access strategy (2003-2013) in Africa, through a review of the literature documenting the long-term consequence of ARV treatment, focusing on medical care for adults with an emphasis on the patient-centered approach. The goal is to understand the interrelationships between biological and social factors and individual and collective aspects that affect the lives of PLHIV and determine the impacts of ARV treatment over the long term. The biomedical and social factors are addressed successively, based on the most significant results. Key knowledge on the long-term outcomes for PLHIVon ARV treatment offers vital information on the necessary conditions and adaptations for care systems needed to ensure the benefits of treatment endure over time.
Plaintes et dysfonctions sexuelles des personnes vivant avec le VIH (PVVIH), traitées par antirétroviraux (ARV) depuis une dizaine d’année au Sénégal
(Springer Science+Business Media, 2014) J. Diaw; Bernard Taverne; J. Coutherut
The sexual health of people who have been living with HIV (PLHIV) and who have been receiving ARV drug treatment for several years is still a virtually unexplored topic in Africa today. A study was conducted in Senegal on people who have been treated with ARVs for ten years. Half of those interviewed believe that their sexuality has deteriorated. HIV infection has become a chronic disease in which sexual dysfunction related to the disease or age is interpreted in the context of popular representations of HIV infection and those on sexuality defined by social norms.
Représentations de l’échec thérapeutique des traitements ARV chez les patients et les professionnels de santé à Dakar
(Springer Science+Business Media, 2014) F. Müller; Bernard Taverne
The aim of this qualitative study was to describe and analyze representations of therapeutic failure and the medical and social responses proposed by health care professionals and patients receiving follow-up in the ANRS cohort 1215 in Senegal from 1999 to 2010. Patients' medical histories show that therapeutic failures are related to complex multifactorial situations, resulting from factors attributable to patients (adherence failure related to various psychosocial problems) but also to health care structures (organization of the health system, training for health care professionals and availability of biological exams and appropriate drugs). Both patients and health care staff recognize these causes. The incidence of the onset of therapeutic failures should be regarded as an indicator of the quality of care provided. Further thought should be given to how well health care systems function when changes occur in these rates.
Twelve years of follow-up for patients treated with ARVs in Senegal (ANRS Cohort 1215): description of population and methodology
(Springer Science+Business Media, 2014) I. Ndoye; Bernard Taverne; B. Taverne
The ANRS Cohort 1215 brought together the first 400 patients receiving antiretroviral treatments through the government program for ARV treatment in Senegal. These people, infected with HIV-1, began their treatment between 1998 and 2002; they were treated with 2 NRTI + 1 PI or NNRTI. This prospective observational cohort received follow-up over the course of 12 years, from 1999 to 2010, and was one of the earliest established cohorts in Africa and providing the longest duration of ART follow-up. A series of interdisciplinary studies was conducted among these patients to assess the medical and social as well as the individual and collective impact of these treatments over the long term. This article presents the cohort's key methodological characteristics.