Immunological Response During HAART and Determinants of Current CD4 T-Cell Count Among HIV/AIDS Patients Attending University of Gondar Referral Hospital, Northwest 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 -value <0.2 in the bivariate analysis were entered in the multiple regression models. -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 [=185.5, 95% CI (8.8, 362.2)] (=0.040), with increased baseline CD4 T-cell count [=0.468, 95% CI (0.342, 0.594)] (<0.0001), and with long duration on HAART [=18.0, 95% CI (9.9, 26.1)] (<0.0001), whereas a decreased level of current CD4 T-cell count was observed among males [=-72.7, 95% CI (-114.5, -30.9)]) (<0.0001) and those with poor baseline adherence [=-108.9, 95% CI (-210.9, -7.0)] (=0.036) and viral load >1000 copies [=-189.2, 95% CI (-243.5, -134.9)] (<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.