IeDEA West Africa WADA: West Africa database on antiretroviral therapy Charlotte Lewden Médecin épidémiologiste, ISPED, Inserm U897, Université de Bordeaux, France Programme PAC-CI

IeDEA International Epidemiologic Databases to Evaluate AIDS International research consortium established in 2005 by the US National Institute of Allergy and Infectious Diseases (NIH) Resource for globally diverse HIV/AIDS data To address research questions in HIV/AIDS unanswerable by single cohorts First round 2006-2011; Second round 2011-2016: currently year 7: July 2012 to June 2013 IeDEA West Africa, 5 June 2013

IeDEA Regions IeDEA West Africa, 5 June 2013 3 3

IeDEA West Africa (WADA) WADA: 16 adult and 11 pediatric centres in 9 countries: Benin, Burkina Faso, Côte d’Ivoire, Ghana, Guinea-Bissau, Mali, Nigeria, Senegal, Togo Coordinating Center: ISPED, Univ Bordeaux Segalen, France Regional Office: PAC-CI, CHU Treichville, Abidjan Côte d’Ivoire IeDEA West Africa, 5 June 2013

WADA Objectives for 2011-2016 To measure the effectiveness of ART in HIV-infected individuals in West Africa in the long-term, and to assess factors that influence program and treatment outcomes To increase the capacity for delivering ART durably in West Africa by increasing the capacity for monitoring clinical outcomes at the individual and population levels in adults and children To document the morbidity burden in HIV-infected individuals in care in HIV programs throughout West Africa. IeDEA West Africa, 5 June 2013

WADA study design Observational prospective multicenter study Pooled database of HIV-infected adults and children data followed in reference clinics in West Africa IeDEA West Africa, 5 June 2013

WADA Sites Country Adults Children Benin 1 urban Burkina Faso 2 Cote d’Ivoire 6 5 urban, 2 semi-rural Ghana Guinea Bissau Guinee Conakry future semi-rural Mali Nigeria Senegal Togo IeDEA West Africa, 5 June 2013

WADA Inclusion criteria 2006-2011 HIV-1 or HIV-2 infected Treatment with ART (antiretroviral combinations) 2011-2016 HIV-infected individuals who initiated ART HIV-2 or HIV-1/HIV-2 infected individuals >18 years, whatever they receive ART or not HIV-exposed children born to HIV-infected mothers until their early infant HIV diagnosis Children with a confirmed HIV-infection whatever the time of ART initiation IeDEA West Africa, 5 June 2013

WADA scientific update and perspectives Response to ART in adults Morbidity Hepatitis Cancer Quality of life HIV-2 and HIV-1/HIV-2 Pediatrics and adolescents Women and mothers (Linkage to care and in care) 9 IeDEA West Africa, 5 June 2013

IeDEA West Africa Observational cohort HIV-infected adults with ART N= 58,611 HIV-2 or (HIV-2 and HIV-1) positive N= 1,933 HIV-exposed children N= 4,079 HIV-infected children without ART N= 526 HIV-infected children with ART N= 4,808 IeDEA West Africa, 5 June 2013

Tables Description Pediatrics Adults Socio-demographic and clinical characteristics at ART initiation /baseline TAB_BAS Biological data (baseline and follow-up) TAB_LAB TCD4+ lymphocytes measurements (baseline and follow-up) TAB_LAB_CD4 TAB_LABCD4 Viral load measurements (baseline and follow-up) TAB_LAB_RNA TAB_LABCV Antiretroviral treatments (ART) TAB_ART TAB_MISEART TAB_SUIART Follow-up TAB_VIS TAB_SUIVI Vital status, date of last contact TAB_OUTCOME TAB_STATUT MTCT TAB_PMTCT_INT TAB_PTME Opportunistic infections - TAB_IO Prophylaxies of opportunistic infections TAB_PROPHYIO Parental health TAB_PAR_HEALTH IeDEA West Africa, 5 June 2013 11

Apport des bases de données pour le suivi des PVVIH Formalisation du recueil de données : fiche standard (pas toujours) Édition de liste de patients en retard de visite pour la relance active des patients perdus de vue Edition d’historiques à partir du dossier du patient (pas toujours) ou visualisation du dossier informatisé pendant la consultation Aide à la décision Gestion de l’approvisionnement en tests et médicaments Rapports aux financeurs Suivi des pratiques, respect des recommandations Recherche Forster_Bul_WHO2008 (Art-Linc); Braitstein_jaids2009 (Kenya); Nash_jaids2009; Douglas_plosmed2010 (Malawi); Ekouevi_curr_opinin_hiv_aids2011 IeDEA West Africa, 5 June 2013

Sine qua non Personnels compétents et en nombre suffisant Maintenance du matériel Sauvegardes Complétude de la base Contrôle de la qualité IeDEA West Africa, 5 June 2013

Inconvénients possibles Base de données incomplète donc inutilisable Redondance des fiches et des tables par ajouts successifs entrainant un surcroit de travail IeDEA West Africa, 5 June 2013

IeDEA West Africa, 5 June 2013