Immunological recovery, failure and factors associated with CD-4 T-cells progression over time, among adolescents and adults living with HIV on Antiretroviral Therapy in Northern Ethiopia: A retrospective cross sectional study

Abstract

BackgroundThis study was aimed to assess immunological recovery, failure, and factors associated with CD-4 T-cells progression over time, among adolescents and adults living with HIV on Antiretroviral Therapy in Northern Ethiopia.MethodsA retrospective cross sectional study was done on 19,525 HIV patients on ART. Data were collected using a data retrieval checklist from a database. All eligible data in the database were exported to Microsoft excel 2010 and then data verification and filtration were done before exporting to STATA 14.0 for analysis. Factors associated with recent CD-4 count were modeled by using Generalized Linear Model poison family.ResultsAmong the patients with advanced HIV infection (< 200 CD-4 T-cell/ mm3) at baseline, only 28.35%, 95% CI (27.45–29.26) of them had immunological recovery (≥ 500 T-cells/mm3). Only 2.14%, 95%CI (1.94%- 2.35%) of the patients had immunological failure. Baseline CD-4 count (Incidence Rate Ratio (IRR) = 1.0007, 95%CI = 1.00069–1.00078), patients from military health care facility (IRR = 1.11, 95%CI = 1.06–1.16), good adherence (IRR = 1.12, 95%CI = 1.04–1.21) and viral load suppression (IRR = 1.31, 95%CI = 1.28–1.33) were positively associated with recent CD-4 count in the full model. Whereas, being male (IRR = 0.85, 95%CI = 0.83–0.86), patients with on Anti-Retroviral Therapy (ART) regimen of 1e (TDF-3TC-EFV), 2f (AZT-3TC-ATV/r), and 2h (TDF-3TC-ATV/r) (IRR = 0.92, 95%CI = 0.91–0.94), (IRR = 0.65, 95%CI = 0.55–0.76) and (IRR = 0.71, 95%CI = 0.63–0.81) respectively were negatively associated with the recent CD-4 count in the full model.ConclusionsImmunological recovery was achieved by 1/3 of the patients despite being on highly active ART (HAART). Therefore, intensive adherence counseling, follow-up and support should be focused on patients with viral non suppression to enhance immunological recovery.

Incidence and factors associated with treatment failure among HIV infected adolescent and adult patients on second-line antiretroviral therapy in public hospitals of Northern Ethiopia: Multicenter retrospective study

“…Even though second-line ART was introduced in Ethiopia ten years prior, few studies have reported about the treatment outcome of second-line therapy. Although there were studies on treatment failure focusing on viral suppression and immunological failure on the failure of ART users [14,15], none of these studies have addressed the effect of patient adherence on second-line ART treatment. To our knowledge, the factors contributing to treatment failure of HIV infected patients on second-line ART have not been investigated in the study area.…”

Expression of Inflammatory Markers RANK, MMP-9 and PTHrP in Chronic Apical Periodontitis from People Living with HIV Undergoing Antiretroviral Therapy

“…According to Desta et al (2019), one-third of the population living with HIV-1, undergoing ART, had full or partial recovery of the immune system, that is, TCD4 + cell count above 500 cells/mm 3 of blood, while only 2% of this population remained at critical levels (below 200 cells/mm 3 of blood) [20]. This shows that the use of ART induces partial or total recovery of the patient's immune system, which justifies the results of the present study, where the expression of inflammatory mediators was similar to non-infected patients.…”

<p>Level of Adherence and Associated Factors Among HIV-Infected Patients on Antiretroviral Therapy in Northern Ethiopia: Retrospective Analysis</p>

“…To come up with the sample, all records in the database were reviewed and all the data that fulfill the eligibility criteria were included in the study. [15][16][17]…”

“…9,10 Optimal adherence to HAART depends on socio-demographic (age, gender), clinical (WHO staging, VL and CD4 count) and health system-related factors. [13][14][15] Although assessing the level of ART adherence and its determinant factors is crucial for further improvement of ART, there were no studies in Northern Ethiopia with a large representative sample size. Therefore, this study aimed to assess the level of self-reported adherence and associated factors among adolescent and adult patients enrolled in ART care in Northern Ethiopia.…”