Change in absolute CD4 count with antiretroviral treatment in resource limited setting: a retrospective cohort study in children in Ethiopia.

BACKGROUND

Although antiretroviral treatment (ART) programmes began in 2003 in Ethiopia, there is scarcity of information about paediatric ART.

OBJECTIVE

The purpose of this study was to describe the changes in absolute CD4 counts among children on ART METHODS: A multicenter retrospective cohort assessment was applied to analyze 336 HIV-infected children who were under 15 years old and on ART (September 2006 - March 2009) using a sample database from seven public hospitals in different regions.

RESULTS

The mean age at the time of ART commencement of the cohort were 5.9 +/- 3.2 years. Median follow-up of the cohort was 12 (Inter quartile range 6 to 18) months. The overall absolute CD4 count change showed an increasing trend from the baseline in all age categories. At age 5 years and above, the baseline CD4 count was very low but the increment was very high up to 12 months. The mean absolute CD4 count change in relation to the duration of ART showed an increasing trend up to 12 months and declined after 18 and 24 months. Severe immunosuppression (SI) at initiation of ART (P < 0.0001; Adjusted OR, 5.3) and age 3-4.9 years were independent predictors of continuing SI up to 6 months. Only SI at 6 months was independently associated with SI at 12 months (P < 0.0001; AOR, 21.4).

CONCLUSION

The majority of children have CD4 count rise after ART and that the slope of rise was greater in older children in the first 12 months of therapy.