Determinants of immunological recovery following HAART among severely immunosuppressed patients at enrolment to care in Northern Ethiopia: a retrospective study

Abstract

ObjectiveThis study aimed to identify determinants of immunological recovery following highly active antiretroviral therapy (HAART) among severely immunosuppressed patients at enrolment to care in Northern Ethiopia.MethodsA retrospective study.SettingThe study was done in Tigray Region, Northern Ethiopia.ParticipantsThe study was done among severely immunosuppressed (<200 CD4 cells/mm3) individuals at initial enrolment to care and whose samples were sent for viral load determination from April 2015 to March 2019 in Tigray Health Research Institute.Main outcomesThe main outcome variable was immunological recovery, modelled using binary logistic regression.ResultsAmong the 9687 patients with severe immunosuppression at enrolment, 2746 (28.35%, 95% CI 27.45% to 29.26%) had immunological recovery following HAART for at least 6 months. Male gender (adjusted OR (AOR)=0.50, p<0.001), age 20–34 years old (AOR=0.33, p<0.001), age ≥50 years old (AOR=0.26, p<0.001), WHO clinical stage III (OR=0.68, p=0.036) and viral non-suppression (AOR=0.38, p<0.001) were strong predictors of immunological failure.ConclusionsImmunological recovery following HAART was low among severely immunosuppressed individuals at enrolment to care. Gender, age, WHO stage III and viral non-suppression were determinants of immunological recovery. Male patients, adolescents and virally non-suppressed patients should be identified as groups at higher risk for immunological failure. Therefore, greater support and intensive counselling should be prioritised among adolescents, men and virally non-suppressed patients for better immunological recovery.

Predictors of Current CD4+ T-Cell Count Among Women of Reproductive Age on Antiretroviral Therapy in Public Hospitals, Southwest Ethiopia

“…These OIs might contribute to the decrement of current CD4 + T-cell counts. 53 Moreover, women with advanced HIV status commonly experience a decreased CD4 cell count, and this in turn means the women experience advanced HIV disease, which is at a high risk of death even after starting ART. 12…”

“…These OIs might contribute to the decrement of current CD4 + T-cell counts. 53 Moreover, women with advanced HIV status commonly experience a decreased CD4 cell count, and this in turn means the women experience advanced HIV disease, which is at a high risk of death even after starting ART. 12 The current study also revealed that women with an initial regimen of first-line ART drugs specifically AZT +3TC+EFV were significantly associated with increased CD4 + T-cell count.…”