Abstract
Although the world has been fighting HIV disease in unity and patients are getting antiretroviral therapy treatment, HIV disease continues to be a serious health issue for some parts of the world. A large number of AIDS-related deaths and co-morbidities are registered every year in resource-limited countries like Ethiopia. Most studies that have assessed the progression of the disease have used models that required a continuous response. The main objective of this study was to make use of appropriate statistical models to analyze routinely collected HIV data and identify risk factors associated with the progression of the CD4+ cell count of patients under ART treatment in Debre Markos Referral Hospital, Ethiopia. In this longitudinal retrospective study, routine data of 445 HIV patients registered for ART treatment in the Hospital were used. As overdispersion was detected in the data, and Poisson-Gamma, Poisson-Normal, and Poisson-Gamma-Normal models were applied to account for overdispersion and correlation in the data. The Poisson-Gamma-Normal model with a random intercept was selected as the best model to fit the data. The findings of the study revealed the time on treatment, sex of patients, baseline WHO stage, and baseline CD4+ cell count as significant factors for the progression of the CD4+ cell count.
Highlights
HIV disease continues to be a serious health issue for resource-limited countries like Ethiopia
CD4+ cell count data obtained from 445 HIV patients on antiretroviral therapy (ART) treatment in Debre Markos Referral Hospital were summarized
A likelihood ratio (LR) test was used to test the null hypothesis that the restriction in the Poisson model was true
Summary
HIV disease continues to be a serious health issue for resource-limited countries like Ethiopia. According to the UNAIDS (2016) fact sheet, there were about 2.1 million new cases of HIV in 2015 globally [1]. About 36.7 million people were living with HIV around the world, and, as of June 2016, 18.2 million people living with HIV were receiving medicine to treat HIV, called antiretroviral therapy (ART). An estimated 1.1 million people died from AIDS-related illnesses in 2015, and 35 million people have died from AIDS-related illnesses since the start of the epidemic. CD4+ cell counts are the primary targets of HIV. The estimation of peripheral CD4+ cell counts has been used as a tool for monitoring disease progression and the effectiveness of antiretroviral treatment (ART) [2]. The changes in the CD4+ cell counts are important indicators of the response to ART
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