Factors affecting CD4+T-lymphocyte count response to HAART in HIV/AIDS patients within 24 months of treatment at Chreso Ministries Art Centre

Abstract

The general objective of this study was to identify factors that affect CD4-TLymphocyte count response in patients commenced on HAART within 24 months of treatment at Chreso Ministries VCT and ART centres. The elements of this study were files of clients of all age groups on HAART above 5 years of age who had at least four consecutive repeat CD4 count rechecks within 24months of treatment with all other necessary information of variables required for this study captured in smartcare at treatment initiation. According to May 2009 statistical report, Chreso Ministries ART centre which happened to be a study site had 7000 HIV positive clients on care and 3900 clients on HAART. This study was a retrospective cohort design and had a sample size of 340 files of clients. The sampling frame generated from the study population was subjected to computerized random selection to come up with the sample size of 340 medical files. The study was purely quantitative and involved reviewing clients’ records that have been captured on the smartcare database on clients who have been on HAART for more than 24months. The extracted data was entered in Epidata using Epi Info and was exported to SPSS for analysis. The Chi-Square test at 5% with crosstabulation tables was used to determine associations between the identified variables and CD4-Lymphocyte count response to HAART and the logistic regression analysis was used to predict the probability of CD4 count response to HAART using the variables of this study. The study was completed in 3months following approval from the Ethics Committee of the University of Zambia. The statement of the problem was the observed poor CD4 count response to treatment in most of the clients commenced on HAART. The factors at hand involved the social demographic factors (age, sex, income, alcohol consumption and employment status) ART factors (Adherence and ART regimen) and immunological factor (CD4 count at treatment initiation). In this study it was found that gender, alcohol consumption, nadire and regimen affects CD4 count response to HAART. It was found that men, non alcohol consumers and those that start HAART with baseline CD4 count above 350 cell/µL experienced a good CD4 response to HAART. Additionally, those who commenced treatment on truvada and devoted themselves to 95% adherence also experienced a good CD4 count response to HAART. On the other hand, age, smoking and employment status did not affect CD4 count response to HAART.