Immunological Response During HAART and Determinants of Current CD4+ T-Cell Count Among HIV/AIDS Patients Attending University of Gondar Referral Hospital, Northwest Ethiopia
Received 2 April 2020
Accepted for publication 12 July 2020
Published 31 July 2020 Volume 2020:12 Pages 295—306
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Bassel Sawaya
Gizachew Ayele Manaye,1 Dejene Derseh Abateneh,1,2 Kindie Mitiku Kebede,1 Alemayehu Sayih Belay1
1Mizan Tepi University, College of Health Sciences, Mizan Tefri, Ethiopia; 2Kotebe Metropolitan University, Menelik II College of Medicine and Health Sciences, Addis Ababa, Ethiopia
Correspondence: Dejene Derseh Abateneh
Kotebe Metropolitan University, Menelik II College of Medicine and Health Sciences Department of Medical Laboratory Sciences, P.O. Box: 3268, Addis Ababa, Ethiopia
Purpose: After the initiation of highly active antiretroviral therapy (HAART), successful HAART is characterized by an increase in the CD4+ count. Several factors affect the CD4+ T-cell count. This study aimed to assess the immunological response during HAART and determinants of the current CD4+ T-cell count among HIV/AIDS patients on HAART.
Patients and Methods: A hospital-based cross-sectional study was conducted from February 1 to April 1, 2017. A total of 423 HIV/AIDS patients on HAART were enrolled using simple random sampling. Descriptive statistics, and bivariate and multiple regression analyses were conducted. Variables with p-value < 0.2 in the bivariate analysis were entered in the multiple regression models. p-Values < 0.05 and 95% confidence intervals were used to identify determinants of the current CD4+ T-cell count.
Results: The mean CD4+ T-cell count gradually increased until 8 years on HAART but declined thereafter. An increased current CD4+ T-cell count was observed among patients with an initial regimen of pediatric d4T-3TC-NVP [β=185.5, 95% CI (8.8, 362.2)] (p=0.040), with increased baseline CD4+ T-cell count [β=0.468, 95% CI (0.342, 0.594)] (p< 0.0001), and with long duration on HAART [β=18.0, 95% CI (9.9, 26.1)] (p< 0.0001), whereas a decreased level of current CD4+ T-cell count was observed among males [β=− 72.7, 95% CI (− 114.5, – 30.9)]) (p< 0.0001) and those with poor baseline adherence [β=− 108.9, 95% CI (− 210.9, − 7.0)] (p=0.036) and viral load > 1000 copies [β=− 189.2, 95% CI (− 243.5, − 134.9)] (p< 0.0001).
Conclusion: The trend in immunological response was not increased linearly throughout the HAART duration. Sex, type of initial regimen, baseline adherence, baseline CD4+ count, viral load, and duration on HAART were independent determinants of current CD4+ count. These determinants could be addressed by regular monitoring of HIV patients on HAART, and special attention should be paid to male patients.
Keywords: immunological responses, trends, current CD4+ count, HIV/AIDS, HAART
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