Factors Affecting CD4 Count Response in HIV Patients within 12 Months of Treatment: A Case Study of Tamale Teaching Hospital

Toyibu Yakubu^1, , Vincent K Dedu² and Patrick Owiredu Bampoh³

¹Sexual Transmitted Infections Clinic, Tamale Teaching Hospital, Tamale, Ghana,

²Department of Mathematics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

³National AIDS Control Programme, Ghana Health Service, Tamale, Ghana

Cite this paper

Toyibu Yakubu, Vincent K Dedu and Patrick Owiredu Bampoh. Factors Affecting CD4 Count Response in HIV Patients within 12 Months of Treatment: A Case Study of Tamale Teaching Hospital. American Journal of Medical and Biological Research. 2016; 4(4):78-83. doi: 10.12691/AJMBR-4-4-3

Abstract

The effectiveness of HIV treatment can be assessed by monitoring the Cluster of Differentiation 4 (CD4) cell counts of HIV positive patients. Changes in CD4 cell counts over time in patients on antiretroviral therapy (ART) could explain how HIV patients respond to treatment (ART). We seek to identify factors that affect Cluster of Differentiation 4 (CD4) cell count response in patients on antiretroviral therapy (ART) within 12 months of treatment at the Tamale Teaching Hospital (TTH) of Ghana. The data was based on the records of patients in the database of the hospital from 2009 to 2013. Factors identified include social (smoking habits, religious affiliation and alcohol consumption) and demographic factors (age, sex and employment status); antiretroviral therapy (ART regimen) and immunological CD4 cell count at the initiation of treatment). However, only two of the variables (Age and Gender) were found to be significant and were therefore included in the model. The rest of the variables did not affect CD4 cell count response to antiretroviral therapy (ART). The results also showed that the model provided a reasonable statistical fit (chi-square value of 10.058 with corresponding probability value of 0.261 which is greater than the level of significance (0.05)). Since age affected (increase) in the CD4 cell counts in response to ART, detection of HIV infections at young age is paramount for early treatment when there the likelihood of significant CD4 cell count increase. This will translate into increased immunity and prolong the lives of HIV patients.

Keywords

CD4 count, HIV, AIDS, Logistic Regression, antiretroviral therapy

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	amfAR, 2014. HIV/AIDS in Asia. [Online] Available at: http://www.amfar.org/around-the-world/treatasia/aids- in asia. [Accessed 20 October 2015].
[2]	Sharma, B. (2014). Oxidative stress in HIV patients receiving antiretroviral therapy. CURRENT HIV RESEARCH 12(6): 13-21. IF 2.033.
[3]	(UNAIDS/WHO, 2008. The Gap Report: Beginning of the end of the AIDS epidemic. [pdf] UNAIDS Information Production Unit. [Available] http://data.unaids.org/pub/Report/2009/jc1736_2008_annual_report_en.pdf [Accessed 13 AUGUST 2015].
[4]	UNAIDS, 2014. The Gap Report: Beginning of the end of the AIDS epidemic. [pdf] UNAIDS Information Production Unit. Available at: <http://data.unaids.org/pub/Report/2009/jc1736_2008_annual_report_en.pdf.> [Accessed 1 AUGUST 2015].
[5]	National AIDS/STI Control Programme Ghana, 2015, HIV Sentinel Survey Report Accra, Ghana
[6]	UNAIDS, 2016. The Prevention Gap Report: Beginning of the end of the AIDS epidemic. [pdf] UNAIDS Information Production Unit. Available at: <http://www.unaids.org/sites/default/files/media_asset/2016-prevention-gap-report_en.pdf>[Accessed 30 AUGUST 2015].
[7]	Ghana AIDS Commission, 2014. COUNTRY AIDS RESPONSE PROGRESS REPORT – GHANA.[pdf] Ghana AIDS Commission, http://www.unaids.org/sites/default/files/country/documents//file,94605,es..pdf. [Accessed 30 July 2015].
[8]	Simone E Langford, Jintanat Ananworanich, David A Cooper AIDS Res Ther. 2007; 4: 11. Published online 2007 May 14.
[9]	Sharma, B. (2014). HIV-1, Neuro-AIDS and Cognitive Impairments. JOURNAL OF NEUROINFECTIOUS DISEASES 5: e103.
[10]	Sharma, B. (2011). The antiHIV-1 drugs toxicity and management strategies. NEUROBEHAVIOURAL HIV MEDICINE 3: 1-14.
[11]	Sharma, B. (2012). Attributes of Host’s Genetic Factors in HIV-1 Pathogenesis. BIOCHEMISTRY AND ANALYTICAL BIOCHEMISTRY. 2012, 1:4.
[12]	Sharma, B. (2015) Drug Resistance in HIV-1: Genetic and Molecular Bases, Mechanisms and Strategies to Combat the Issue. BIOCHEMISTRY AND ANALYTICAL BIOCHEMISTRY, 4:e153.
[13]	(WHO, 2011. Participants Manual for WHO Basic ART Clinical Training Course: Integrated Management of Adolescent and Adult Illness. [pdf] Geneva: WHO Document Production Services. http://www.who.int/hiv/pub/imai/en/partmanualbasicartfinal.pdf. [Accessed 8 August 2015]).
[14]	Stohr, w. 2007. HIV medicine journal. Volume 8, Blackwell publishing, uk.
[15]	Ajayi, A. O., Ajayi, E. A., & Fasakin, K. A. (2009). CD4+ T-lymphocytes cell counts in adults with human immunodeficiency virus infection at the medical department of a tertiary health institution in Nigeria. Annals of African Medicine, 8(4):257-60.
[16]	Allison A. 2008. HIV Laboratory Monitoring, http://www.aidsalliance.org/publications. >.
[17]	WHO, UNAIDS, UNICEF (2004), Towards Universal Access. Scaling up priority HIV/AIDS interventions in the health sector. Progress report 2004. World Health Organization, Geneva 2004. Available at: http://www.who.int/hiv/pub/2004progressreport/en/ [Accessed March 28, 2013]].
[18]	Ghana news agency, 2015. HIV Prevalence Goes Down. [Online] Available at: http://ghanaweb.com/GhanaHomePage/NewsArchive/health.php. > [September 22, 2015].
[19]	Sackoff, J.E., Hanna, D.B., Pfeiffer, M, R., Torian, L.V. 2006. Causes of death among persons with AIDS in the era of highly active antiretroviral therapy. Ann Intern. New York.
[20]	Luguterah, A., & Adams, M. 2013. Growth Dynamics of CD4 cells in HIV-1 Patients on Antiretroviral Therapy (ART) at the Builsa District Hospital in Ghana. American Journal of Medical and Biological Research.
[21]	Southern African Journal of HIV Medicine, 2013. Gender inequality: Bad for men's health.[pdf] Johannesburg: Health &Medical Publishing Group. Available at: http://www.sahivsoc.org/upload/documents/SAJHIVMED%20Vol%2014%20No%201.pdf [Accessed 15 November 2015].
[22]	Conen A et al. Association of alcohol consumption and HIV surrogate markers in participants of the Swiss HIV Cohort Study. J Acquir Immune Defic Syndr, online edition.
[23]	Baum MK et al. Alcohol use accelerates HIV disease progression. AIDS Research and Human Retroviruses, online edition.
[24]	Kebede MM, Zegeye DT, Zeleke BM (2014) Predictors of CD4 Count Changes after Initiation of Antiretroviral Treatment in University of Gondar Hospital, Gondar in Ethiopia, Japan. Clin Res HIV/AIDS 1(2): 1008.
[25]	Agresti, A. 2007. An Introduction to categorical data analysis. 2nd Edition, John Wiley and Sons, Inc., New York.