title: CD4 cell count trends after commencement of antiretroviral therapy among HIV-infected patients in Tigray, Northern Ethiopia: a retrospective cross-sectional study.
abstract: BACKGROUND
  The rate and extent of CD4 cell recovery varies widely among HIV-infected patients with different baseline CD4 cell count strata. The objective of the study was to assess trends in CD4 cell counts in HIV-infected patients after initiation of antiretroviral therapy in Tigray, Northern Ethiopia.
  
  
  METHODS
  A retrospective cross-sectional study was conducted by reviewing medical records of HIV patients who received antiretroviral treatment at twenty health centers in Tigray region during 2008-2012. Multi-stage cluster sampling technique was employed to collect data, and the data were analyzed using SPSS version 20.0 software.
  
  
  RESULTS
  The median change from baseline to the most recent CD4 cell count was +292 cells/μl. By 5 years, the overall median (inter-quartile range, IQR) CD4 cell count was 444(263-557) cells/μl while the median (IQR) CD4 cell count was 342(246-580) cells/μl among patients with baseline CD4 cell counts ≤200 cells/μl, 500(241-557) cells/μl among those with baseline CD4 cell counts of 201-350 cells/μl, and 652(537-767) cells/μl among those with baseline CD4 cell counts >350 cells/μl. Higher baseline CD4 cell counts and being male were independently associated with the risk of immunological non-response at 12 months. Furthermore, it was also investigated that these factors were significant predictors of subsequent CD4 cell recovery.
  
  
  CONCLUSIONS
  Patients with higher baseline CD4 cell stratum returned to normal CD4 Cell counts though they had an increased risk of immunological non-response at 12 months compared to those with the least baseline CD4 cell stratum. The findings suggest that consideration be given to initiation of HAART at a CD4 cell count >350 cells/μl to achieve better immune recovery, and to HIV-infected male patients to improve their health seeking behavior.
authors: Department of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
authors: Addisu
authors: A
authors: Asfaw
authors: Department of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
authors: Dagim
authors: D
authors: Ali
authors: Department of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
authors: Tadele
authors: T
authors: Eticha
authors: Department of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
authors: Adissu
authors: A
authors: Alemayehu
authors: Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
authors: Mussie
authors: M
authors: Alemayehu
authors: Advocacy and Communication HIV Division, Social Mobilization, Tigray Regional Health Bureau, Mekelle, Ethiopia.
authors: Filmon
authors: F
authors: Kindeya
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count / Q000639:trends; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies