Background: Anemia is the most common hematologic abnormality in HIV patients and is associated with disease progression and decreased survival. This study aims to describe the prevalence and predictors of anemia in HIV positive patients at the time of ART initiation at public health facilities of Arba Minch town, Southern Ethiopia. Methods: A total of 411 adults (≥15 years) HIV positive patients with complete information on hemoglobin levels and CD4 count and clinical characteristics registered from 2006 to 2013 were assessed for anemia prevalence and risk factors at the ART clinic of the Arba Minch hospital and health center. The measurements of Hemoglobin and CD4 + T cell count were performed using standard methodology at baseline of ART initiation. Results: A total of 411 HIV positive patients (195 males and 216 females) with a mean ± SD age of 33.9 ± 9.0 years were assessed. Hemoglobin levels were between 6.0 and 16.5 mg/dL. The overall prevalence of anemia at the time of ART initiation was 52.3%; with 28.1%, 22.9% and 1.3% mild, moderate and severe anemia respectively. The overall prevalence of anemia was 62.4% A. G. Alamdo et al. 1658 among males and 46.7% among females (P < 0.001). An increased risk of anemia was seen in males (adjusted OR = 2.78, 95% CI = 1.77 -4.35); low CD4 cell counts (adjusted OR = 3.48, 95% CI = 2.09 -5.79); and history of TB (adjusted OR = 2.89, 95% CI = 1.28 -6.54). Conclusions: Anemia in HIV-positive patients was highly prevalent at the time of ART initiation. Male gender, low CD4 count and history of TB were associated with higher risk of baseline anemia.

Background: There are two approved non-nucleoside reverse transcriptase inhibitor antiretroviral drugs; namely Nevirapine (NVP) and Efavirenz (EFV). Nevirapine and EFV have comparable clinical efficacy when administered in combination regimens. But there is a lack of recent evidence showing the effect of NVP and EFV-based ARTs on immunological responses in HIV infected individuals in Ethiopia in general and Addis Ababa in particular. Methods: Retrospective cohort study design was used to compare immunological response rate of NVP and EFV based HAART regimen in Addis Ababa. Four hundred ninety two HIV infected patients who started HAART in ten selected health facilities were included in the study. Rate of immunologic response was examined at the 6 th , 12 th , 18 th , and 24 th months of follow-up period. The time required to get immunological response was analyzed by Kaplan-Meier survival curve. Adjusted hazard ratio was calculated with a 95% confidence interval by Cox proportional hazards model to determine the rate of immunological response. To ascertain the association, bivariate and multi variable Cox proportional hazard model was used. Statistical significance was considered with two sides P-value of 0.05. Results: The mean CD4 count ranged between 132.2 cell/µl at baseline and 302.3 cell/µl at the end of the follow-up period. This change was significant at 95% of CI but did not show significant differences among the comparison group. The median time to get immunological response was 18 (75% percental 12) months. At the end of the follow-up period, 73.2% (76.6% for NVP and 69.8% for EVF P-value 0.13) of the study population had immunological response. Conclusion: As a conclusion, there was a robust and sustained CD4 response and the effect of NVP and EFV based ART on change of mean CD4 count and immunological response was comparable and effective. Initiation of ART with high baseline CD4 count, in combination of IPT and with either NVP or EFV based NNTI was recommended.

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