Immunological and clinical progress of HIV-infected patients on highly active antiretroviral therapy in north west Ethiopia

Abstract

The survival benefits of highly active antiretroviral therapy (HAART) in HIV infected patients have been studied well in the developed world. In resource poor settings like Ethiopia such treatment was started only in 2003. As a result, the existing treatment guidelines and recommendations are based on data from the developed world. The objective of this study was to determine the immunological and clinical progress in HIV/AIDS patients in one year data review of patients' card who initiated on HAART in Ethiopia. A retrospective cohort study was done based on past medical records of HIV/AIDS patients, using a structured data collection format. All patient cards of one year data with patients who initiated HAART from October 1, 2006 to November 30, 2007 were included in the study. The data collected was analyzed using SPSS for window version 16.0. The majority of the study population (383, 64.2%) were prescribed zidovudine/lamivudine/neverapine (ZDV/3TC/NVP) regimen initially. Overall functional status change showed that ability to work was increased by 31.5%, being ambulatory decreased by 93.4% and bedridden status decreased by 80%. A total of 240 (46.9%) patients have showed functional status improvement. Average mean weight change of 5.9 kg (increment by 11.9%) was seen during a one year follow-up. The patients showed immunological change from 132.883 mean CD4/mm 3 count to 335.87 mean CD4/mm 3 . About 492 (82.4%) patients present with different type of opportunistic infections (OIs) at start of therapy which dramatically dropped to only 40 (6.7%) patient after one year of receiving HAART. HAART initiation has decreased progression of the diseases and improved the patients' quality of life. Most patients have showed a significant increment in their CD4 count. The restoration of CD4 in turn has improved the clinical status of most patients. Despite the significant progression of health of patients, greater immunological and clinical success should be attained by encouraging patients for effective use of those lifesaving drugs with maximal adherence. 2) başlangıçta zidovudin/lamivudin/neverapin (ZDV/3TC/NVP) tedavisi verilmişti. Genelde fonksiyonel durum değişimi, çalışma yeteneğinin %31.5 arttığını, ayakta tedavi edilmenin %93.4 azaldığını, yatağa bağlı kalma durumunun %80 azaldığını gösterdi. Toplam 240 hasta fonksiyonel durum düzelmesi gösterdi. Bir yıllık izleme sırasında 5.9 kg ortalama ağırlık değişimi (%11.9 artma) gözlendi. Hastalar ortalama 132.883 CD4/mm 3 sayımından ortalama 335.87 CD4/mm 3 'e immünolojik değişim gösterdi. Tedavinin başlamasında farklı tipte fırsatçı enfeksiyonu bulunan yaklaşık 492 (%82.4) hasta, HAART tedavisi başlamasından bir yıl sonra dramatik olarak sadece 40'a (%6.7) düştü. HAART tedavisi başlanması hastalığın ilerlemesini azalttı ve hastaların yaşam kalitesini iyileştirdi. Hastaların çoğu CD4 sayılarında anlamlı artışlar gösterdi. CD4'deki düzelme birçok hastanın klinik durumunu iyileştirdi. Hastaların sağlığındaki anlamlı iyileşmeye karşın, hayat kurtaran bu ilaçlara d...

Assessment of Duration of Staying Free from Acquiring Rehappening Opportunistic Infections among Pre-ART People Living with HIV/AIDS between 2008 and 2013

“…In about a quarter (22.7%) of PLWHA, chronic diarrhea was seen in Southern Ethiopia [ 16 ]. The cumulative incidence of recurrent OIs like recurrent upper respiratory tract infection, chronic diarrhea, bacterial pneumonia, oral candidiasis, herpes zoster, extra pulmonary tuberculosis, PCP, and pulmonary tuberculosis in current study was 17.1%, 14.8%, 9.8%, 9.8%, 9.3%, 9.3%, and 7%, 5.4%, respectively, and this finding is relatively in line with some figures of OIs in the studies [ 9 , 10 , 12 – 14 ] though it is lower than some other studies [ 11 , 15 , 16 ]. The possible reasons for discrepancy would be different in study design (the prior ones that are cross-sectional), study population (prior ones using PLWHA when coming to initiate ART which will increase the prevalence since ART is initiated using WHO stage of disease and CD4 count), study area, and other sociocultural practices.…”

“…In Northwest Ethiopia, about 88.9% pre-ART HIV patients had OIs [ 10 ]. Another study in similar area also showed that 82.4% pre-ART HIV patients have OIs [ 11 ]. The respective prevalence of pulmonary tuberculosis and cryptococcal meningitis among PLWHA in North West Ethiopia was about 7.5% [ 14 ] and 8.3% [ 15 ].…”

“…A national study in Ethiopia showed HIV patients' had OIs like Herpes Zoster scar (19.3%), pulmonary tuberculosis (5.2%), and pneumonia (5.2%) [ 9 ]. The respective prevalence of OIs in pre-ART HIV patients' in two studies in Northwest Ethiopia was 88.9% [ 10 ] and 82.4% [ 11 ].…”

Immune recovery among HIV-infected patients in northwestern Tanzania after 2 years of anti-retroviral therapy use: a retrospective cohort study

“…The correct use of antiretroviral (ARV) drugs significantly reduces viral load resulting in reduced morbidity and mortality among HIVinfected patients (Egger et al, 2002;Edwards et al, 2015). Studies have shown that prolonged viral suppression is associated with substantial increases in CD4 cell counts and reduction in the rates of opportunistic infections associated morbidity and mortality * Correspondence E-mail: benkidenya@yahoo.com (Battegay et al, 2006;Wabe & Alemu, 2012). Such immune recovery has been shown to be partial consisting of an initial rapid recovery of CD4 T lymphocytes as well as improvement in their function (García et al, 2004;Moore & Keruly, 2007;Zhou et al, 2010).…”