title: Highly active antiretroviral therapy and employment status in accra, ghana.
abstract: OBJECTIVE
  This study investigated the immunologic responses and employment history of highly-active antiretroviral therapy (HAART) patients.
  
  
  METHODS
  We interviewed patients and reviewed medical records to collect demographic, clinical, and employment history while on HAART. Demographic characteristics were tested as predictors of immunological response while on HAART using hierarchical linear models.
  
  
  METHODS
  Fevers Unit, Korle-Bu Teaching Hospital, Accra, Ghana
  
  
  METHODS
  Subjects comprised a convenience sample of adult HAART patients receiving therapy for at least 9 months. 270 patients were interviewed. 38 were excluded due to inadequate time on HAART or inability to locate all necessary patient information.
  
  
  METHODS
  This was an observational study.
  
  
  METHODS
  We investigated the change in CD4 cell count and weight since the initiation of therapy, and their ability to maintain or regain employment as well as the reasons for this.
  
  
  RESULTS
  The estimated mean ± standard error increase in CD4 cell count from baseline at 6, 12, and 18 months were 102 ± 5, 204 ± 11, and 236 ± 10 cells/µL, respectively. Overall, 147 patients (63.4%) reported remaining employed or obtaining new employment while on HAART. Patients who were asymptomatic at initial presentation were more likely to remain employed or returned to work while on HAART than those who were symptomatic (66.4% vs. 48.8%, P = 0.009). Most patients were employed in the informal sector, which made their economic situation particularly vulnerable to HIV-associated illness.
  
  
  CONCLUSIONS
  The findings suggest that patients receiving HAART experience good clinical and immunological responses as well as improvement in employment status.
authors.affiliation: Brown Medical School, Box G-A8355, Providence, Rhode Island 02912, United States.
authors.forename: Iw
authors.initials: I
authors.lastname: Howley
authors.forename: M
authors.initials: M
authors.lastname: Lartey
authors.forename: J T
authors.initials: JT
authors.lastname: Machan
authors.forename: E A
authors.initials: EA
authors.lastname: Talbot
authors.forename: A
authors.initials: A
authors.lastname: Obo-Akwa
authors.forename: T P
authors.initials: TP
authors.lastname: Flanigan
authors.forename: A
authors.initials: A
authors.lastname: Kwara