title: Factors associated with poor CD4 and viral load outcomes in patients with HIV/AIDS.
abstract: Suboptimal viral suppression and CD4 response to antiretroviral treatment (HAART) is known to cause poor outcomes with the increase cost of treatment. We aimed to assess factors associated with such control among HIV/AIDS patients in Malaysia. Four hundred and six HIV/AIDS patients, using Antiretroviral Therapy (ART) for at least the past three months, treated as outpatients at medication therapy adherence clinics (MTAC) were recruited. CD4 cell counts, viral load readings along with co-variants such as socio-demographic factors, adverse drug reactions, comorbidities, and medication record were obtained. Statistical Package for Social Sciences (SPSS(®)) version 18 and STATA IC(®) version 12 were used for data analysis. CD4 counts were found highest among those within the age category 41-50 years (390.43 ± 272.28), female (402.64 ± 276.14), other ethnicities (400.20 ± 278.04), and participants with no formal education (414.87 ± 290.90). Patients experiencing adverse effects had a 2.28 (95%CI:1.25-4.18) fold greater risk of poor CD4 control, while patients with comorbidities had 2.46 (95%CI:1.02-5.91) fold greater risk of mild viral suppression. Adverse drug reactions, co-morbidities were found to be significantly associated with poor immunological and virological outcomes in HIV/AIDS patients. However, a comprehensive evaluation is needed to better understand other confounders.
authors.affiliation: School of Pharmaceutical Sciences, Universiti SainsMalaysia (USM), Malaysia.|School of Pharmacy, International Medical University, Malaysia.
authors.forename: Imran Ahmed
authors.initials: IA
authors.lastname: Syed
authors.affiliation: School of Pharmaceutical Sciences, Universiti SainsMalaysia (USM), Malaysia.
authors.forename: Syed Azhar Syed
authors.initials: SA
authors.lastname: Sulaiman
authors.affiliation: School of Pharmaceutical Sciences, Universiti SainsMalaysia (USM), Malaysia.
authors.forename: Mohammad Azmi
authors.initials: MA
authors.lastname: Hassali
authors.affiliation: School of Pharmacy, University of Queensland, Australia.
authors.forename: Shahzad Hasan
authors.initials: SH
authors.lastname: Syed
authors.affiliation: School of Pharmacy, International Medical University, Malaysia.
authors.forename: Lau Hui
authors.initials: LH
authors.lastname: Shan
authors.affiliation: Department of Medicine, Hospital Sungai Buloh, Selangor, Malaysia.
authors.forename: Christopher K C
authors.initials: CK
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017211:Treatment Failure; D019562:Viral Load; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
keywords: CD4 outcomes; HIV & AIDS; anti-retroviral therapy; factors associated; viral suppression