Pattern and predictors of cluster of differentiation 4 (CD4) cell count recovery among cohorts of human immunodeficiency virus (HIV)-infected patients on antiretroviral therapy in Hawassa University Referral Hospital

Abstract

Cluster of differentiation 4 (CD 4 ) cell count recovery is used in determining disease progression and outcome monitoring. This study was conducted to determine the trends of CD 4 cell count recovery, and its determinants in Hawassa university referral hospital, Ethiopia. Retrospective cohort study design was employed to gather relevant data among human immunodeficiency virus (HIV) positive-patients visiting Hawassa University referral hospital. Data were collected from December 1, 2014 to May 15, 2015. A total of 2400 medical records of adult patients aged above 15 years were examined. Of these, 1479 were evaluated and analyzed. Multivariate logistic regression was constructed to determine predictors of change in CD cell count. The median change in CD 4 cell count from baseline to six months was 124 cells/μl. 19.3% of patients were at risk of immunologic non-response at 12 months of treatment. Patients with a baseline CD 4 cell count of less than 100 cells/ml were 5 times more likely to exhibit immunologic non-response compared to those with a baseline CD 4 cell count > 350 cells/μl. Baseline body mass index (BMI) and sex were associated with failure to attain ≥200 cells/μl at 12 months of treatment. Rapid recovery of CD 4 cell count occurred during the first six months of treatment in this study. However, significant proportions of patients were at risk of immunologic non-response. Low baseline CD 4 cell counts were predictive of non-response in this setting. The findings suggest that initiation of antiretroviral therapy (ART) at a CD 4 cell count greater than 500 cells/μl is associated with better immune recovery.

<p>Assessment of Pattern of CD4+ T-Cell Recovery Among Human Immunodeficiency Virus Patients After Initiation of Highly Active Antiretroviral Therapy at Arsi Negelle Health Center, Ethiopia: A Retrospective Cross-Sectional Study</p>

“…23,24 This finding was also in line with other studies. 14,21 The median of CD4+ T-cell at baseline was 257cells/uL which was higher than a baseline median of the study done in Hawassa university referral hospital (167cells/uL). 14 The difference could be explained by the fact that our study included all participants of the age group.…”

“…14,21 The median of CD4+ T-cell at baseline was 257cells/uL which was higher than a baseline median of the study done in Hawassa university referral hospital (167cells/uL). 14 The difference could be explained by the fact that our study included all participants of the age group. A high proportion of patients exhibited immunologic nonresponse (22.1%) after 12 months of treatment, a proportion similar to that observed in a study conducted in Northern Ethiopia (22.7%) 7 but higher than the study done in Hawassa, southern Ethiopia (19.3%).…”

“…The immunological non-response rate was defined as an increase of <50 cells/uL after HAART treatment. 14 The immunological non-response rate of the study participants is shown in Figure 3. The percentages of patients who failed to attain an absolute CD4+ T-cell count increase of at least 50cells/uL at 12 months was 22.1%.…”

“…Even though some studies in Ethiopia address the immunological none response rate and CD4 recovery, 7,14 to the best of our knowledge, there are no studies from the study area concerning rates of CD4 + T-cells recovery and rates of immunological non-response to ART among HIV-infected patients. Therefore, we conducted a retrospective study to assess the trends of CD4 cell recovery among HIV patients after the initiation of antiretroviral therapy in Negelle, southeastern Ethiopia.…”

The Relationship Between Baseline Cd4 T Cells’ Level and Recovery Rate After Initiation of Art in Hiv/Aids Infected at Hospital for Tropical Diseases, Vietnam

“…However, the clinical and immunological responses among patients in AIDS stages and others are mixed. Some studies have shown that recovery response is strongly related to baseline CD4 count [5,6]. Many researches have shown that patients with lower baseline CD4 are recovery worse [7][8][9].…”