**3.3 Antiretroviral therapy in SCD patients**

If we agree to distinguish Homozygous patients from their heterozygous counterpart regarding the HIV carriage, it makes sense to do the same in the matter of ARVT.

Regarding first homozygous HbSS patients, to the best of our knowledge, no evidence exist on the use of ARVT on them. However, on observing a short cohort of 5 patients in our practice at the Central Hospital of Yaoundé in Cameroun in to the last 5 years, our standard

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protocol of ARVT has been well tolerated by homozygous HbSS patients, provided all the other measures of SCD control are well conducted.

In the contrary, we have more heterozygous SCD patients with HIV carriage under ARVT; as said above; the tolerance and efficiency of ARVT on them does not differ from the general non SCD population.

### **3.4 Summary of section C**

There is very little evidences and experience on how to manage patients demanding arthroplasty, in cases where they are simultaneously HIV and SCD carriers. This little experience shows that those who are heterozygous should be managed as non SCD patients. In those who are homozygous, a simultaneous protocol of SCD care protocol as presented in section B, should be added.
