Nutritional status and other predictors of immune response recovery among HIV-AIDS patients receiving antiretroviral therapy in Dr. Sardjito Hospital, Yogyakarta, Indonesia: a retrospective cohort study

Abstract

Introduction: Nutritional status and immune response of Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome (HIV-AIDS) patients are closely connected. There are limited studies assessing the influence of Body Mass Index (BMI) on immune response recovery among HIV patients in Indonesia. This study aimed to identify the BMI and other predictors of immune response recovery among HIV-AIDS patients following two years of Antiretroviral (ARV) therapy. Methods: This research was a retrospective cohort study among HIV-AIDS patients who started ARV therapy from January 2014 to December 2016 at Dr. Sardjito Hospital, Yogyakarta. Data were collected from ARV registry and medical reports. Data were analysed using linear regression. Results: A total of 255 patients were included in the study, with a median BMI of 20.07 kg/m2. Results showed that BMI was not significantly correlated with immune response recovery at the 6th, 12th, 18th, and 24th months of ARV therapy (p>0.05). But, the increase in cluster of differentiation 4 (CD4) cell count was higher in overweight and pre-obese patients than underweight patients, especially in the 18th and 24th months of therapy. Factors related to immune response recovery were the regularity of treatment at the 12th, 18th, and 24th months of ARV therapy, and the use of Tenofovir at 18th-month therapy (p<0.05). Conclusion: Immune response recovery was higher in overweight and pre-obese patients. Using Tenofovir type ARV and doing treatment regularly can increase CD4 cell counts. Underweight patients need to enhance their nutritional status to improve their immune response during ARV therapy.