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Determinants of immunological recovery of Hiv/Aids patients under antiretroviral treatment

Author: 
Zelalem Getahun Dessie
Subject Area: 
Physical Sciences and Engineering
Abstract: 

CD4 counts are one of the factors used to measure disease progression in HIV-positive individuals. CD4 counts vary in individuals and across populations due to a variety of demographic, environmental, immunological and genetic factors that probably persist throughout the course of HIV infection. The purpose of this study is to examine factors affecting immunological recovery of a patient under ART treatment. A sample of 710 patients has been taken from a hospital record at Bahir-Dar Felege-Hiwot Referral Hospital, Bahir Dar, Ethiopia from June 2006 to August 2013. Kaplan-Meier estimation method and Cox regression model were applied. From the Kaplan-Meier, female patients, baseline CD4 count>200cell/µl, TB negative, total lymphocyte count≥1200 cell/mm3, and baseline weight≥60kg has contributed to a shortened time to immunological recovery at 5% significant level. From Cox regression model result, male patient (adjusted HR=0.535), lower CD4 count of ≤200cell/µl (adjusted HR=0.59), lower lymphocyte count of <1200 cells/mm3 (adjusted HR=0.59), patients who have severe anemia (adjusted HR=0.42) and lower baseline weight of <60kg (adjusted HR=0.964) were significantly associated to longer time to immunological recovery at 5% significant level. Negative tuberculosis Patients (adjusted HR=1.44) was significantly associated to shortened time to immunological recovery at 5% significant level. In conclusion, the findings of this study shows that sex, TB status, anemia status, baseline CD4 counts, baseline lymphocyte counts, and baseline weight are major factors related to immunological recovery of AIDS patient. I recommend that physicians need to be cautious about the baseline health status of a patient, as it may affect his/her time to immunological recovery.

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