Abstract
BackgroundHighly Active Antiretroviral therapy (HAART) reverses the effect of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) by durably suppressing viral replication. This allows CD4 gain to levels that are adequate enough to restore the body’s capability to fight against opportunistic infections (OIs). Patients with poor immune recovery have been shown to have higher risk of developing both AIDS and non AIDS related clinical events. This study aimed at assessing the proportions and risk factors of poor immune recovery in adult HIV-infected patients on 48 months of HAART attending care and treatment center (CTC) in northwestern Tanzania.MethodsA retrospective analysis of adult HIV patients’ data attending CTC at Sekou Toure hospital and who initiated HAART between February 2004 and January 2008 was done. Poor immune recovery was defined as a CD4 count less than 350 cells/µl on follow up as used in other studies.ResultsA total of 734 patients were included in the study. In this study 50.25% of patients attending CTC at Sekou Toure hospital were found to have poor immune recovery. The risk of developing inadequate immune recovery was independently associated with male gender, age older than 50 years, low baseline CD4 counts, and advanced World Health Organization (WHO) clinical stage.ConclusionsPoor immune recovery is prevalent among adult HIV patients attending CTC at Sekou Toure hospital in Northwestern part of Tanzania and opportunistic infections are common in this sub group of patients. Clinicians in resource limited countries need to identify these patients timely and plan them for targeted viral assessment and close clinical follow up to improve their long term clinical outcome.
Highlights
Active Antiretroviral therapy (HAART) reverses the effect of Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/acquired immune deficiency syndrome (AIDS)) by durably suppressing viral replication
Immune reconstitution was defined as cluster of differentiation 4 (CD4) count ≥350 cells/μl; at 48 months of follow up and those patients who had CD4 counts
In our study we found that male gender was strongly associated with poor immune recovery where male patients were 1.52 times more likely to have poor immune recovery than females
Summary
Active Antiretroviral therapy (HAART) reverses the effect of Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) by durably suppressing viral replication. This allows CD4 gain to levels that are adequate enough to restore the body’s capability to fight against opportunistic infections (OIs). Our study aimed at determining the proportion and risk factors of poor immune recovery in adult HIV patients on standard HAART for 48 months in Northwestern Tanzania This will assist clinicians in Tanzania and other resource limited settings to be able to identify potential patients who may possibly benefit from targeted viral load testing and close clinical follow up
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