Pattern and predictors of immunologic recovery in HIV infected patients.
BACKGROUND
Although anti-retroviral therapy has generally improved the survival of HIV infected patients in many developing countries including Ghana, specific socio-demographic factors could still influence outcome of treatment. This study was designed to identify patient-specific factors that could influence the immune recovery of absolute CD4 count in HIV infected patients.


RESULTS
Hospital records were extracted from two health facilities in Ghana. The impact of socio-demographic factors type of ART and baseline category of CD4 counts were assessed at six monthly interval using robust linear mixed models.


RESULTS
A total of 214 follow up records were reviewed at Komfo Anokye Teaching Hospital (KATH) and the Kumasi South Hospital (KSH). One hundred (46.7%) were from KATH and 114 (53.3%) were from KSH. There was a general increase in the level of CD4 counts with time, however this increase significantly slowed down with subsequent reviews (p < 0.001). On the average the rate of CD4 count recovery slowed down by 43.6 cells/µl for every 6 months of follow up (SE = 7.69; p < 0.001). Similarly the recovery of CD4 counts in subjects with an initial high baseline CD4 counts decreased by 192.6 cells/µl (SD error = 42.3, p value ≤0.001). All other variables were not significantly associated with recovery of CD4 counts.


CONCLUSIONS
Our study has demonstrated the well-known phenomenon of CD4 counts increasing after administration of ARTs. CD4 counts increased more rapidly in those with relatively lower initial counts, catching up with those with high CD4 count by 2 years post treatment.
Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. tbenkwofie@yahoo.com.
Theophilus B
TB
Kwofie
Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana. owusumichael-gh@hotmail.com.
Michael
M
Owusu
Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. mutocheluh@gmail.com.
Mohamed
M
Mutocheluh
Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana. sbnguah@gmail.com.
Samuel Blay
SB
Nguah
Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana. jbobeng@gmail.com.
Joseph
J
Obeng-Baah
Laboratory Department, Kumasi South Hospital, Kumasi, Ghana. shi_hansen@hotmail.com.
Charlotte
C
Hanson
Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana. adompreh@gmail.com.
Albert
A
Dompreh
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count / Q000706:statistics & numerical data*; D005260:Female; D005869:Ghana; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000502:physiology; D054884:Host-Pathogen Interactions / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D020127:Recovery of Function / Q000187:drug effects / Q000276:immunology; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects
D019380:Anti-HIV Agents