Mekdes, Solomon (2017) Immuno-Virological Response and its Association with Inflammation Marker Creactive Protein, Clinical and Socio-Demographic Factors among HIV patients at Least 12 Months on Antiretroviral Therapy at Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Masters thesis, Addis Ababa University.
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Abstract
Background: Highly active antiretroviral therapy (HAART), has significantly reduced the mortality of HIV infected population but, the morbidity attributed to it remained a serious concern. The magnitude and factors associated with Immuno-virologic responses to HAART are less investigated. Objective: To assess Immuno-virologic response and its association with inflammation, Clinical and Socio-demographic factors after at least 12 months of HAART initiation among patients attending Zewditu Memorial Hospital, Addis Ababa, Ethiopia Method: A hospital based prospective cross sectional as well as retrospective longitudinal study was conducted from January to June 2016 at Zewditu Memorial Hospital. Socio-demographic and clinical information was collected from ART database of 402 HIV patients who were on HAART for at least 12 months. Blood was collected from when participants come for their scheduled second follow up visit since ART initiation and examined for CD4 count and, viral load. Serum sample was separated for C-reactive protein determination. Descriptive statistics was used to determine the socio demographic characteristics and response rates. Binary and multiple logistic regressions were computed to assess associations between variables using SPSS version 20. P value less than 0.05 was considered as statistically significant. Result: From the 402 participants 235(58.5%) were females. Majority 174(43.8) were in the age group of 30-39 years, attained high school 184(45.9%) and were married 193(48.0%). Most participants 159(39.6%) were on 1e regimen (TDF+3TC+EFV) and have normal BMI 224(55.7%). About 99.5% of them were on OI drugs. Concordance response was noted in 311(77.4%) participants while 16 (4.0%) failed both immunologically and virologically. Despite virological response, 55(13.7%) participants failed to restore CD4 count of at least 50 cells/ mm3 after 12 months of HAART. Majority of CRP positive participants were in the unfavorable responder category. Participants having CD4>350 cells/ mm3 (adjusted odds ratio = 0.06; 95% CI: 0.02-0.19) and viral load < 1000 copies/ml (adjusted odds ratio = 0.26; 95% CI: 0.13-0.55) at baseline were significantly associated factors of immuno-virological discordant responses Conclusion: Individuals who had a baseline CD4 count above 350 cells/ mm3 and baseline viral load below 1000 copies/ml were less likely to have discordant response. Though the concordance response rate is high (77.4%), the proportion of patients failing immunologically (13.7%) despite virologic response, signifies the importance of virologic monitoring of HAART responses. Simple markers like CRP could supplement monitoring of unfavorable responses.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | HIV, CD4, Viral-load, CRP, Concordant response, Discordant response |
| Subjects: | Q Science > QR Microbiology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Africana |
| Depositing User: | Emmanuel Ndorimana |
| Date Deposited: | 24 Oct 2018 08:29 |
| Last Modified: | 24 Oct 2018 08:32 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/7057 |
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