Multilevel model on longitudinal data analysis in determinants of CD4 cell count among antiretroviral therapy attendant of HIV infected adults follow up in Gondar Teaching Referral Hospital, Gonder, Ethiopia

Kindu Kebede

doi:10.1186/s12981-020-00329-5

Abstract

BackgroundHuman immunodeficiency virus attacked an immune cell and the CD4 cell which is responsible for the body’s immune to infectious agents. Acquired immunodeficiency syndrome is one of the major public health problems in Sub-Saharan Africa including Ethiopia. The main objective of this study to identify the determinants of CD4 cell count among antiretroviral therapy attendants of infected adults follow up in Gonder teaching referral hospital, Gonder, Ethiopia implemented by SAS version 94.MethodsA retrospective cohort study was conducted on 216 regular follow up patients whose age greater than 14 years from December 1, 2012, to December 30, 2017. A multilevel model was used to identify the factors of CD4 cell count of patients and it considered variability between and within patients.ResultsThe mean with a standard deviation of weight, and a hemoglobin level of patients were 55.48 (10.21), and 18.25 (33.028) respectively. This study concluded that the variation for CD4 cell count existed between patients was 63% and the remaining 37% of variation existing within patients. In this study, the random coefficient time-varying covariate model was well fitted which shows weight and hemoglobin level were statistically significant predictors at a 5% level of significance for the log of CD4 cell count of patients.ConclusionThis study shows the hemoglobin level and weight of patients were statistically significant for the log of CD4 cell count of patients follow up in Gonder teaching referral hospital, Gonder, Ethiopia. Moreover, the result of the study shows that the log of CD4 count of patients increased when hemoglobin level and weight of patients increased. Hence, intervention should be given the ways to increase weight and hemoglobin levels of patients during follow up of antiretroviral therapy.

Highlights

Acquired Immune Deficiency Syndrome (AIDS) is caused by Human immunodeficiency virus (HIV) (Human Immune Deficiency Virus) which reduces a person’s ability to fight infection
Women account for nearly half of the 40 million people living with HIV-1 worldwide which has a higher proportion existing in developing countries and the human immunodeficiency virus–type 1 (HIV-1) is epidemic for more than 20 years [2]
Such nested structures are typically strong hierarchies because 63% of the variation for Cluster of differentiation four (CD4) count existed between patients and the remaining 37% of variation existing within patients

Summary

Introduction

Acquired Immune Deficiency Syndrome (AIDS) is caused by HIV (Human Immune Deficiency Virus) which reduces a person’s ability to fight infection. HIV attacks an immune cell and the CD4 cell is responsible for the body’s immune response to infectious agents. Kebede AIDS Res Ther (2021) 18:5 of blood. These CD4 cells, decrease in number with time from HIV, so that an infected person’s CD4 cell count can be used to monitor the progression of the disease [1]. Human immunodeficiency virus attacked an immune cell and the CD4 cell which is responsible for the body’s immune to infectious agents. The main objective of this study to identify the determinants of CD4 cell count among antiretroviral therapy attendants of infected adults follow up in Gonder teaching referral hospital, Gonder, Ethiopia implemented by SAS version 94

Results

Discussion

Conclusion