Department of Statistics, College of Natural Science, Adigrat University, Adigrat, Ethiopia.
Department of Epidemiology and Biostatistics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Immunol. 2024 Oct 4;25(1):64. doi: 10.1186/s12865-024-00659-3.
HIV has an effect on lowering CD4 cell count, which lowers the ability to resist contamination. For patients on ART in areas with limited resources, the CD4 cell count assessment is crucial for determining treatment responses and therapeutic decisions. The volatility of CD4 counts following the introduction of ART over time is still largely uncharacterized, and there are few fresh datasets on CD4 cell count progressions. The goal of this study was to identify the key factors that change over time in CD4 cells for HIV/AIDS patients receiving ART follow-up in northern Ethiopia.
A total of 216 HIV/AIDS patients who initiated ART in the Mekelle General Hospital between 2013 and 2016 were involved using systematic random selection techniques. An examination of exploratory data was used to describe the individual profiles of HIV patients. A multivariable random intercept and slope linear mixed regression analysis regarded predictor variables to be statistically significant if their p-value was less than 0.05.
The random intercept and slope linear mixed model result indicated that there were statistically significant predictors of baseline CD4 cell count (β = 0.0125, P-value = 0.001*) and bedridden functional status (β = -2.459, p = 0.02*) on the change of CD4 cell count over time in HIV/AIDS patients at the 5% significance level.
Changes in CD4 counts were influenced by the baseline CD4 cell count and the functional status of being bedridden. Because their CD4 cell counts were lower at baseline and they had a functional status of bedridden, the majority of HIV/AIDS patients on ART had substantial predictors on the change of CD4 cell count over time. So, public health service providers should give exceptional guidance and attention is also necessary for those patients who have lower baseline CD4 cell count and bedridden functional status.
HIV 会降低 CD4 细胞计数，从而降低抵抗感染的能力。对于资源有限地区接受 ART 治疗的患者，CD4 细胞计数评估对于确定治疗反应和治疗决策至关重要。随着时间的推移，ART 引入后 CD4 计数的波动性在很大程度上仍未得到充分描述，并且关于 CD4 细胞计数进展的新数据集很少。本研究的目的是确定在埃塞俄比亚北部接受 ART 随访的 HIV/AIDS 患者 CD4 细胞随时间变化的关键因素。
采用系统随机抽样技术，选取 2013 年至 2016 年期间在梅克莱综合医院接受 ART 治疗的 216 名 HIV/AIDS 患者。使用探索性数据分析方法描述 HIV 患者的个体特征。多变量随机截距和斜率线性混合回归分析认为，如果预测变量的 p 值小于 0.05，则具有统计学意义。
随机截距和斜率线性混合模型结果表明，在 HIV/AIDS 患者的 CD4 细胞计数随时间变化方面，基线 CD4 细胞计数（β=0.0125，P 值=0.001*）和卧床功能状态（β=-2.459，p=0.02*）是具有统计学意义的预测因素。
CD4 计数的变化受基线 CD4 细胞计数和卧床功能状态的影响。由于他们的基线 CD4 细胞计数较低且处于卧床功能状态，因此大多数接受 ART 治疗的 HIV/AIDS 患者对 CD4 细胞计数随时间的变化有很大的预测作用。因此，公共卫生服务提供者应该为这些患者提供特殊的指导和关注，这些患者的基线 CD4 细胞计数较低且处于卧床功能状态。
