Infection par le VIH meconnue : circonstances de decouverte et pronostic en milieu de medecine interne a Lome

Objectifs: Le but de ce travail etait de decrire les circonstances de decouverte et le pronostic de l’infection par le VIH chez les patients ne se connaissant pas seropositifs en milieu de Medecine Interne a Lome. Methodologie: Il s’agit d’une etude retrospective menee de Janvier 2015 a Decembre 2017 au service de Medecine Interne (Medecine B) du CHU SylvanusOlympio. Resultats: Durant la periode d’etude, 431 PVVIH ont ete recus dans le service (en consultation externe et en hospitalisation) dont 70 ne se connaissaient passeropositifs. L’âge moyen etait de 40,41 ans (extremes de 20 et 70 ans) avec une sex-ratio (H/F) de 0,62 (27 hommes et 43 femmes). Tous les patients etaient infectes par le VIH de type 1. L’infection a ete decouverte par un depistage volontaire chez 4 patients (5,71%). Elle a ete revelee par les signes majeurs de la classification de l’OMS chez 11 patients (15,71%) dont 6 cas d’amaigrissement et 5 cas de fievre prolongee, et par diverses manifestations chez 55 patients (78,57%) : manifestations neurologiques (n=22), hematologiques (n=18), digestives (n=16), dermatologiques (n=10), pulmonaires (n=4) et renales (n=4). Le taux moyen de CD4 etait de 168,07cellules/ul de sang (extremes de 1 et 821). La duree moyenne de sejour pour les patients hospitalises etait de 12,51jours (extremes de 1 et 30jours). Le taux de mortalite globale etait de 17,14% (n=12). Conclusion: Cette etude montre que l’infection par le VIH meconnue est frequente au service de Medecine Interne (Medecine B) du CHU Sylvanus Olympio de Lome avec un taux de mortalite eleve. Mots cles: VIH meconnu, Complications, Mortalite, Prevention English Title: Unrecognized HIV Infection: circumstances of discovery and prognosis in internal medicine in Lome  English Abstract Objective: The purpose of this study was to describe the circumstances of discovery and prognosis of HIV infection in patients who were not aware of their seropositive status in Internal Medicine in Lome. Method: This is a retrospective study conducted from 1st January 2015 to 31st December 2017 in the department of internal medicine (Medicine B) of the Sylvanus Olympio teaching hospital of Lome Result: During the study period, 431 persons living with HIV were registered in the department of Internal Medicine (Medicine B). Among them, 70 were not aware of their seropositive status. The mean age was to 40, 41 years old, ranging from 20 to 70 years old. The sex ratio was to 0, 62 (27 men against 43 women). All the patients were infected by HIV-1. The infection has been discovered by voluntary testing in 4 patients (5, 71%). It has been revealed by major signs of the WHO‘s classification in 11 patients (6 cases of weight-loss and 5 cases of prolonged fever). Various manifestations revealed the infection in 55 patients (78, 57%): Neurological disorder (n=22), hematological disorder (n=18), digestive disorder (n=16), dermatological manifestation (n=10), pulmonary events (n=4), kidney disorder (n=4). The mean CD4 count was 168,07cells/ul ranging from 1 to 821.The average length of stay for hospitalized patients was12, 5 days ranging from 1 to 30 days. The overall mortality rate was 17, 14% (n=12). Conclusion: This study shows that Unknown HIV infection is frequent in the Internal Medicine Service of the (Medicine B) of the Sylvanus Olympio teaching hospital of Lome with a high mortality rate. Key-words: HIV, Ignorance, Complications, Mortality, Prevention