జర్నల్ ఆఫ్ క్లినికల్ అండ్ సెల్యులార్ ఇమ్యునాలజీ
అందరికి ప్రవేశం

నైరూప్య

The Pattern of CD4⁺ T Cell Recovery and Determinants of HIV Infected Individuals Receiving Highly Active Antiretroviral Treatment in Mekelle Hospital, Tigray Northern Ethiopia: A Retrospective Study

Letebrhan Weldemhret, Abraham Aregay, Hadish Bekurtsion, Gebremicheal Gebreegziabher, Tsehaye Asmelash, Dawit Gebreegziabher Hagos

Background: With the development of antiretroviral treatment, the incidence of HIV-related illness and death has significantly decreased. Nevertheless, some individuals living with HIV who are taking Anti-Retroviral Therapy (ART) do not fully respond to the treatment in terms of immune restoration. This research aimed to examine the CD4⁺ T cell recovery pattern and factors influencing immune reconstitution among people with HIV on ART in Mekelle Hospital, Tigray, Northern Ethiopia.

Methods: A retrospective cross-sectional study involving HIV-positive patients receiving ART followup care was conducted in the hospital from January 2010 to July 2020 data was gathered through the utilization of a pre-tested structured questionnaire, which was administered by skilled data collectors. Statistical analysis was conducted using SPSS V. 20, with bivariate and multivariate analyses carried out to identify possible predictors of immune reconstitution after ART administration, 0.05% was considered as cut of level statistical significance.

Results: Out of the 424 study participants, 58% (248) were female, with a mean age of 37 ± 9. The ART follow-up lasted for a median duration of 60 months (IQR: 36-84), while the most recent median CD4⁺ T-cell count was 388 cells/μl (interquartile range: 254-527). The mean increase in CD4 cell count compared to the pre-ART level was 166 cells/μl of blood. Significant predictors associated with CD4⁺ T-cell recovery characterized by >350 cells/μl increments after long-term ART uptake were identified as follows: the age range of 25-34 years (Adjusted Odds Ratio [AOR] 2.62, 95% confidence interval [CI]: 0.82-8.35), baseline CD4⁺ T-cell count >200 cells/μl (AOR 3.53, 95% CI: 2.23-5.58), duration of ART follow-up of 12, 48, and 49 months or longer (AOR 8.053, 95% CI: 1.45-44.84; AOR 4.82, 95% CI: 1.16-20.11; AOR 6.36, 95% CI: 1.63-24.77), and TDF-3CT-Efv ART drug combination (AOR 2.29, 95% CI: 1.32-3.97).

Conclusion: The extent of immune recovery in people with HIV relies on the duration of their ART treatment and the CD4⁺ T-cell count at the time of initiation. Furthermore, individuals who received the TDF-3CT-Efv ART drug combination showed a faster restoration of CD4⁺ T-cells compared to those who were prescribed other ART drug regimens.