Abstract

Cluster of differentiation 4 (CD₄) cell count recovery is used in determining disease progression and outcome monitoring. This study was conducted to determine the trends of CD₄ cell count recovery, and its determinants in Hawassa university referral hospital, Ethiopia. Retrospective cohort study design was employed to gather relevant data among human immunodeficiency virus (HIV) positive-patients visiting Hawassa University referral hospital. Data were collected from December 1, 2014 to May 15, 2015. A total of 2400 medical records of adult patients aged above 15 years were examined. Of these, 1479 were evaluated and analyzed. Multivariate logistic regression was constructed to determine predictors of change in CD cell count. The median change in CD₄ cell count from baseline to six months was 124 cells/μl. 19.3% of patients were at risk of immunologic non-response at 12 months of treatment. Patients with a baseline CD₄ cell count of less than 100 cells/ml were 5 times more likely to exhibit immunologic non-response compared to those with a baseline CD₄ cell count > 350 cells/μl. Baseline body mass index (BMI) and sex were associated with failure to attain ≥200 cells/μl at 12 months of treatment. Rapid recovery of CD₄ cell count occurred during the first six months of treatment in this study. However, significant proportions of patients were at risk of immunologic non-response. Low baseline CD₄ cell counts were predictive of non-response in this setting. The findings suggest that initiation of antiretroviral therapy (ART) at a CD₄ cell count greater than 500 cells/μl is associated with better immune recovery.

Key words: Antiretroviral therapy, CD4 cell count, HIV/AIDS, Ethiopia.