Etsehiyiwot, G/Michael (2017) Trends in CD4 Count Recovery and Clinical Characteristics of HIV-Infected Patients Initiating Antiretroviral Therapy in Yekatit 12 Hospital Medical College. Masters thesis, Addis Ababa University.
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Abstract
Background: HIV is isolated in 1983, human immunodeficiency Virus (HIV), the agent that causes acquired immune deficiency syndrome (AIDS), is classified as members of the lentivirus subfamily of retroviruses. Although HAART is known to profoundly suppress viral replication, it increases CD4 cell count and delays disease progression and death; patients on Highly Active Antiretroviral Therapy (HAART) commonly suffer from side effects of the drug. Each antiretroviral drug is associated with specific adverse effects. Objective: The aim of this retrospective cohort study was to describe immunological response among HIV-infected individuals receiving highly active antiretroviral therapy (HAART) with long-term follow-up. Method: A Cohort retrospective study design was conducted to assess immunological (the CD4+ recovery) among HIV-infected individuals receiving highly active antiretroviral therapy (HAART) with long-term follow-up. ART-naive patients with symptomatic HIV disease at baseline (before ART) and after 6 and 9 and 12 months of ART was collected from records. Result: A total of 887 HIV positive patients involved in this research; Out of these 472 (53.2%) were female and 415 (46.8%) male patients. None of them have any opportunistic infection during the time of follow up. The mean age of the study group was 36.76 (17-76). The mean baseline CD4+ count was 81.40; the mean CD4 count at the 6th, 9th and 12th month was 191.65, 284 and 331 respectively. There was a good immune recovery at the 6th month of therapy from the baseline mean CD4+ T cell count of 81 cells/l to 191.65 cells /l, which was statistically significant (p<0.0001). This first remarkable rise was continued in the achieving in the mean CD4+ count of 284 cells/l at the 9th month of visit. Followed by relatively steady lower increase and approaching stable CD4+ T cell count and 12th months of visit. Conclusion: In this study, although good CD4 cells recovery in response to ART was documented in more than 81% of follow-up cases, HIV-positive patients were enrolled in ART program at decreased CD4 cells levels. As there is poor recovery of CD4 cell when the start <200 than when they start ART at CD4 count >200 CD4 cell therefore, interventions need to be designed to promote early HIV testing and early enrollment of HIV infected individuals into ART services. ART has considerably improved the immune recovery. We strongly recommend the need of ART in HIV infected patients for immune reconstitution should be started as early as possible. The differential recovery rate between those with base line CD4+ T cell count below 50cells/l and above 500cells/l needs further investigation.
Item Type: | Thesis (Masters) |
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Uncontrolled Keywords: | Immunological response, CD4count, HAART |
Subjects: | Q Science > QR Microbiology R Medicine > R Medicine (General) |
Divisions: | Africana |
Depositing User: | Vincent Mpoza |
Date Deposited: | 30 Oct 2018 13:28 |
Last Modified: | 30 Oct 2018 13:29 |
URI: | http://thesisbank.jhia.ac.ke/id/eprint/7125 |
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