title: Improvement in immunological parameters in patients receiving highly active anti-retroviral therapy in Nepal.
abstract: Highly active anti-retroviral therapy (HAART) has been freely available in Nepal since 2004. In the present longitudinal study, we followed two distinct cohorts of human immunodeficiency virus-infected participants, those receiving HAART and those under assessment of eligibility for HAART, during the period 2005-2007 in Kathmandu, Nepal. The median change in CD4+ T-cell count among participants receiving HAART after 12 months of the initiation of therapy was +118 T cells/μl (95% confidence interval [CI], +91 to +145 T cells/μl) and that among participants under assessment of eligibility for HAART was -74 T cells/μl (95% CI, -103 to -44 cells/μl). However, the median CD8+ T-cell count after 12 months remained stable in both the cohorts (P > 0.05). The CD4+/CD8+ T-cell ratio increased from 0.16 to 0.26 after 12 months of therapy (P < 0.001). The multivariate regression model revealed that participants >30 years of age, and injection drug users had significantly lower increases in the CD4+ T-cell count in response to therapy. We observed a high proportion of loss to follow-up after 12 months of therapy; however, the associated factors were unknown. In conclusion, we observed a significant improvement in the CD4+ T-cell count in participants receiving HAART; however, the CD4+/CD8+ T-cell ratio remained <0.5 after 12 months of treatment.
authors.affiliation: School of Health and Allied Science, Pokhara University, Pokhara.
authors.forename: Bishnu Raj
authors.initials: BR
authors.lastname: Tiwari
authors.forename: Surendra
authors.initials: S
authors.lastname: Karki
authors.forename: Prakash
authors.initials: P
authors.lastname: Ghimire
authors.forename: Bimala
authors.initials: B
authors.lastname: Sharma
authors.forename: Sarala
authors.initials: S
authors.lastname: Malla
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009390:Nepal; D016896:Treatment Outcome
chemical_list: D044966:Anti-Retroviral Agents