Body Mass Index Status Determines Absolute CD4+ Count in Adult HIV/AIDS Patients on Antiretroviral Therapy in Zambia

Abstract

Objective: To determine if Body Mass Index would predict absolute CD4 count to suggest its contribution towards immune augmentation and viral suppression among the victims of HIV/AIDS. Design and methods: The researchers conducted a cross sectional-quantitative study involving 174 adult HIV/AIDS patient participants who were enrolled over a period of 18 months at Ndola Teaching Hospital in Ndola, Zambia. Participants were subjected to clinical assessments with anthropometry, viral load, CD4+ count and plasma fat measurements at control and repeated on a follow-up visit. The Wilcoxon rank sum analysis was used to analyze the quantitative parameters while the Chi square analysis was applied to analyze nominal variables by sex respectively. The main research question was addressed by establishing the association between Body Mass Index and CD4 count, adjusted for potential confounders using the multiple linear regression model. Results: The BMI was within the normal range for both male and female gender, although notably higher in the females [median=22.9; interquartile (20.4,27.5) kg/m2] than in the males [median=21; interquartile (18.8,23.9) kg/m2], p=0.01. The median CD4+ counts were found to be lower than the lower limit of the normal for the laboratory reference range of (500-1500 cells/ul) in both genders. There was a positive correlation between CD4+ count and the BMI in both unadjusted [Coef=0.05; 95%, CI(0.03,-0.08), p=0.00] and adjusted [Coef=0.04; 95% CI(0.00,0.07), p=0.03] models respectively. Similarly, there was a positive correlation between CD4+ count and the BMI [Coef=0.04; 95% CI(0.00,0.08), p=0.04], reported in the adjusted model for the female gender. Conclusion: Body mass index was found to be positively correlated with absolute CD4 count, and more substantively so by female gender.