Exploration of Long-term CD4 Profile in HIV Patients Under HAART at Mizan-Tepi University Teaching Hospital and Tepi General Hospital, South Western Ethiopia

Solomon Abebaw Andargie,Assaye Belay Gelaw

doi:10.11648/j.pamj.20200905.12

Abstract

Currently, because of the wide availability and free service of HAART, HIV/AIDS related morbidity and mortality has decreased significantly. However, patients accessing antiretroviral treatment (ART) programmes in sub-Saharan Africa frequently have very advanced immunodeficiency and various reserches suggest that such patients may have diminished capacity for CD4 cell count recovery. The objective of this study was to investigate the long-term effect of highly active antiretroviral therapy on the CD4 lymphocyte count of HIV-infected Patients. Subjects from the multicenter HAART Program cohort (from Mizan-Tepi University Teaching Hospital and Tepi General Hospital), aged 18 years or older and had an ART treatment start date in between February 1, 2017 to January 31, 2019 were enrolled in the present study and followed for a maximum of 3 years. Liner mixed model with nested random effect were used to model the longitudianl CD4 count over time. The data reveal robust CD4 responses to ART that are continual over several years. Being under HAART for long period and having baseline CD4 count greater than 150 were positively associated with CD4 increment over time while starting ART at late stage (Stage 3 or 4) and being male are negatively assocted with CD4 increment over time. These study show strong and repetitive CD4 response to ART among patients remaining on therapy. Earlier HIV diagnosis and initiation of ART could significantly progress patient outcomes in the study area.

Highlights

Acquired Immune Deficiency Syndrome antiretroviral treatment (ART) (AIDS) is a disease in which the immune system of a body becomes weak and unable to fight against opportunistic infections and other illness which take the advantage of the weaken immune system
The HIV/AIDS Anti Retroviral Treatment WHO (HAART) data used in this study was obtained from Mizan-Tepi University Teaching Hospital and Tepi General Hospital HIV/AIDS clinic, South Western Ethiopia
Patients become eligible for HAART with either a documented CD4 count less than 200 cells/mm3 or if they are classifed as WHO stage 4

Summary

Introduction

AIDS is a disease in which the immune system of a body becomes weak and unable to fight against opportunistic infections and other illness which take the advantage of the weaken immune system. The number of people living with AIDS at the end of 2017 was estimated to be more than 34 million, with 2.5 million new infections and 1.7 million deaths. More than two-thirds (69 percent) of all people living with HIV, 23.5 million, live in sub-Saharan Africa—including 91 percent of the world’s HIV-positive children. An estimated 1.2 million adults and children died of AIDS, accounting for 71 percent of the world’s AIDS deaths in 2011. The epidemic still remains high in Sub-Saharan Africa indicating that this region is still the most severely affected region [1, 3, 4, 7, 8]

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