Journal of Blood & Lymph

Predictors of Sub-Optimal CD4 Recovery during the First Six Months of Anti-Retroviral Treatment (ART) in HIV Infected Children: A Retrospective Cross Sectional Study from Tikur Anbessa Tertiary Hospital, Addis Ababa, Ethiopia

Abstract

Abebe Sorsa

Background: Highly active anti-retroviral therapy (HAART) has brought significant change in reducing morbidity and mortality among children living with HIV/AIDS. Decisions concerning initiation and/or shifting of antiretroviral therapy (ART) are guided by monitoring the laboratory parameters of plasma HIV RNA (viral load) and CD4+ T cell count in addition to the patient’s over all clinical response. The demonstrations of the prognostic value of the CD4 cell count was of major importance in the development of therapeutic strategies. Therefore, the objective of this study was to assess factors predicting suboptimal CD4 cell recovery during first six months of ART. Methods: The study is retrospective cross sectional study to assess factors predicting suboptimal CD4 cell recovery. Medical records of patients’ were retrieved and important variables are captured to standard questionnaire tool. T-test is used to assess changes in CD4 cell count after initiation of ART. Binary logistic and multiple regressions were used to assess factors predicting CD4 cell recovery. Results: Data of 360 children were analyzed. CD4 cell count at the start of HAART ranged from 3-2003 cell/mL with an interquartile range of 231-317 cell/mL. After 6 months of HAART, the CD4 cell count has increased ranging from 71-2300 cell/mL with inter quartile range of 458-612 cell/mL and mean CD4 cell count difference of 230, 95%CI (199.414-260.613); P<0.001. Advanced clinical stage of the disease, severe degree of immunosupression, presence of anemia, presence of chronic diarrhea at base line, poor weight gain during first six months of HAART adversely affect the trends of CD4 recovery. Conclusion: Our study demonstrated that advanced clinical stage of the disease, severe degree of immunosupression, presence of anemia at baseline and presence of chronic diarrhea, poor weight gain during first six months of HAART were factors adversely affect the trends of CD4 recovery.