scholarly journals Predictors associated with the variation of CD4 Cell Count and Body Mass Index (BMI) for HIV Positive adults Under ART

2021 ◽  
pp. e00820
Author(s):  
Awoke Seyoum Tegegne
2020 ◽  
Author(s):  
Awoke Seyoum Tegegne ◽  
Principal Ndlovu Ndlovu ◽  
Temesgen Zewotir Zewotir

Abstract Objective The rate of prevalence of HIV/AIDS among adults has been increasing in Sub-Sahara African countries over the last decade. Currently, an estimated number of 722, 248 people are living with HIV, 23, 000 people are newly infected with HIV and 11,000 people are died because of AIDS related illness. The purpose of this study was to identify the most significant variables associated with the variation of CD4 cell count and body mass index (BMI) of HIV positive adults who initiated HAART at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia. Methods To analyze the long-term CD4 cells count and body mass index of HIV infected adults, a prospective follow-up study of 792 HIV-infected patients was performed. A joint model was employed to identify the variables associated with the variation of CD4 cell count and body mass index of adults receiving HAART. A random of 792 samples was taken among charts in the hospital. Results Among the main effects, Socio-demographic variables (Level of education, level of exposedness of disease to persons living together, Marital status and residence area), individuals characteristics (age and weight), economic factors (ownership of cell phone, level of income), clinical factors (baseline CD4 cell count), level of retention (time to follow ups, food and medical adherence) and economic factors(owner of cell phone) significantly affected the variables of interests. Similarly, the interaction effects of time of follow-up visits * cell phone ownership, follow-up visits * gender, age * sex significantly affected both response variables through a linear link function in current investigation. Conclusion Socio-demographic, individual and Clinical variables had significant effect on CD4 cell count and BMI in HAART medication program. Time to follow ups in the HAART program had also direct and significant effect on the variables of interest.


2020 ◽  
Author(s):  
Awoke Seyoum Tegegne ◽  
Principal Ndlovu Ndlovu ◽  
Temesgen Zewotir Zewotir

Abstract Background: The rate of prevalence of HIV among adults has been increasing in Sub-Sahara African countries over the last decade. Currently, an estimated number of 722, 248 people are living with HIV, 23, 000 people are newly infected with HIV and 11,000 people are died because of AIDS related illness. The objective of this study was to identify the most significant variables associated with the variation of CD4 cell count and body mass index (BMI) of HIV positive adults who initiated HAART at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia. This study also aimed to compared the precision of parameter estimates conducted by separate and joint models.Methods: To analyze the long-term CD4 cells count and body mass index of HIV infected adults, a cohort longitudinal study of 792 HIV-infected patients was performed. A joint model was employed to identify the variables associated with the variation of CD4 cell count and body mass index of adults receiving treatment at Felege Hiwot Teaching and specialized Hospital. A random of 792 samples was taken among patients using individual charts in the hospital.Results: Among the main effects, Socio-demographic variables (Level of education, level of disclosure of the disease to persons living together and Marital status ), individuals factors(age, weight and gender), economic factors (ownership of cell phone, level of income), clinical factors (baseline CD4 cell count) retention (food and medication adherence, follow-up time/visit) significantly affected the variables of interests. Similarly, the interaction effects of follow-up times/visits * cell phone ownership, follow-up times/visits * gender, age * gender of patients significantly affected both response variables in current investigation.Conclusion: Socio-demographic, individual and Clinical variables had significant effect on CD4 cell count and BMI in HAART medication program. Follow-up time/visit in the HAART program had also direct and significant effect on the variables of interest. Older HIV patients should be targeted by appropriate public health actions, such as opportunistic screening and easier access to healthcare service. The patients should be advised to disclose the disease to get support from communities around them.


2021 ◽  
Author(s):  
Awoke Seyoum Tegegne

Abstract Background: The use of structural equation modelling and latent variables remains unusual in epidemiology despite its potential usefulness and assessment of casual relations. Measuring direct and indirect effect of latent variables helps for proper intervention and for the ART program to be effective. The main objective of current investigation was to assess casual relations, direct and indirect effect of latent covariates on CD4 cell count change for HIV positive adults under HAART. Methods: Based on the repeated measures of CD4 cell count change data obtained in ART section at Felege Hiwot Teaching and Specialized hospital, AMOS software was employed parameter estimation. The data was conducted on 792 randomly selected HIV positive adults. The data was collected by the health staff for sake of delivering medication adherence. Results: CD4 cell count change was directly and indirectly affected by the latent variables. The powers of effects of observed variables with and without latent variables were a little bit different from each other. Hence, the power effect of observed variables with latent variables was lower as compared to without latent variables. The direct effect of latent variables on the response variable was a little bit greater than indirect effect. Conclusion: The power of effects of observed variables were stronger than their effects with latent variables. Hence, the latent variables had significant contributions for progress of CD4 cell count change. Health related education about the direct and indirect effect of latent variables should be given for patients under HAART.


2020 ◽  
Author(s):  
Awoke Seyoum ◽  
Principal Ndlovu Ndlovu ◽  
Temesgen Zewotire Zewotire

Abstract Background: The prevalence of HIV/AIDS among adult individuals has been increasing in Sub-Sahara African countries over the last decade. In Ethiopia , the prevalence of HIV among adults was 1%. Hence, 23, 000 people were newly infected with HIV and 11,000 people were died because of AIDS related illness in 2018. The purpose of this study was to identify the most significant socio-demographic, economic, individual and clinical determinants of CD4 cell count change in HIV positive adults who initiated HAART at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia. Methods: A secondary and retrospective study design was conducted on 792 HIV positive adults. A structural equation modeling was employed to identify the socio-demographic and clinical covariates that have a statistically significant effect on the status of CD4 cell count change. Results: Literate patients, patients living with partner, patients living in urban area, patients disclosed the disease to family members, high income , ownership of cell, age and sex (male) were statistically significant variables. Conclusion: There was direct relation between socio-demographic variables with retention of HIV positive individuals in HAART program. There was also a direct and significant effect of clinical variables on adherence competence and adherence on CD4 cell change. Retention of patients in the HAART program had direct and significant effect on CD4 cell count change. This finding will be important for policy makers, health officials and for patients to easier access to healthcare service. Keywords: Socio-demographic, clinical factors, individual characteristics, Structural equation, CD4count change


PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e4165 ◽  
Author(s):  
Penelope K. Ellis ◽  
Willam J. Martin ◽  
Peter J. Dodd

Background CD4 cell count in adults with human immunodeficiency virus (HIV) infection (PLHIV) not receiving antiretroviral therapy (ART) influences tuberculosis (TB) risk. Despite widespread use in models informing resource allocation, this relationship has not been systematically reviewed. Methods We systematically searched MEDLINE, Aidsinfo, Cochrane review database and Google Scholar for reports in English describing TB incidence stratified by updated CD4 cell count in cohorts of HIV-positive adults (age ≥15 years) not on ART (PROSPERO protocol no: CRD42016048888). Among inclusion criteria were: reporting precision for TB incidence, repeated CD4 measurements, and TB incidence reported for those not on ART or monotherapy. Study quality was assessed via the Newcastle-Ottawa tool for cohort studies. A Bayesian hierarchical model was fitted to estimate the pooled factor increase in TB incidence with respect to CD4 cell count decrement. Results A total of 1,555 distinct records were identified from which 164 full text articles were obtained. Common reasons for exclusion of full texts were: no valid TB incidence, no repeat CD4 measurements, and not reporting TB incidence by ART status. The seven studies included reported on 1,206 TB cases among 41,271 individuals, with a typical median follow-up of four years. Studies were generally rated as moderate or high quality. Our meta-analysis estimated a 1.43 (95% credible interval: 1.16–1.88)-fold increase in TB incidence per 100 cells per mm3 decrease in CD4 cell count. Discussion Our analysis confirms previous estimates of exponential increase in TB incidence with declining CD4 cell count in adults, emphasizing the importance of early ART initiation to reduce TB risk in PLHIV.


2020 ◽  
Vol 222 (Supplement_1) ◽  
pp. S8-S19 ◽  
Author(s):  
Carl J Fichtenbaum ◽  
Heather J Ribaudo ◽  
Jorge Leon-Cruz ◽  
Edgar T Overton ◽  
Markella V Zanni ◽  
...  

Abstract Background Patterns of antiretroviral therapy (ART) use and immunologic correlates vary globally, and contemporary trends are not well described. Methods The REPRIEVE trial (Randomized Trial to Prevent Vascular Events in HIV) enrolled persons with human immunodeficiency virus (HIV) who were aged 40–75 years, receiving ART, and had low-to-moderate cardiovascular disease risk. ART use was summarized within Global Burden of Disease (GBD) super-regions, with adjusted linear and logistic regression analyses examining associations with immune parameters and key demographics. Results A total of 7770 participants were enrolled, with a median age of 50 years (interquartile range, 45–55 years); 31% were female, 43% were black or African American, 15% were Asian, 56% had a body mass index >25 (calculated as weight in kilograms divided by height in meters squared), and 49% were current or former smokers. The median CD4 T-cell count was 620/µL (interquartile range, 447–826/ µ L), and the median duration of prior ART use, 9.5 years (5.3–14.8) years. The most common ART regimens were nucleoside/nucleotide reverse-transcriptase inhibitor (NRTI) plus nonnucleoside reverse-transcriptase inhibitor (43%), NRTI plus integrase strand transfer inhibitor (25%), and NRTI plus protease inhibitor (19%). Entry ART varied by GBD region, with shifts during the trial enrollment period. In adjusted analyses, entry CD4 cell count and CD4/CD8 ratio were associated with GBD region, sex, entry regimen, duration of ART, and nadir CD4 cell count; CD4 and CD8 cell counts were also associated with body mass index and smoking status. Conclusions There were substantial variations in ART use by geographic region and over time, likely reflecting the local availability of specific medications, changes in treatment guidelines and provider/patient preferences. The analyses of CD4 cell counts and CD4/CD8 ratios may provide valuable insights regarding immune correlates and outcomes in people living with HIV. Clinical Trials Registration NCT02344290.


2020 ◽  
Vol 8 (4) ◽  
pp. 283-290
Author(s):  
A. Amoko ◽  
P.O. Ajiboye ◽  
F.A. Olagunju ◽  
R.O. Shittu

Objective: Depression is a common mental health problem among people living with HIV/AIDS (PLWHA); because low count of lymphocytes with  cluster of differentiation 4 (CD4 cell count) is associated with severe symptoms of HIV infection, there are thoughts that low CD4 cells count can provoke depressive illness. This study was conducted to determine the relationship between CD4 count and depression among adult HIV positivepatients attending Family Medicine clinics at University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria.Method: A hospital based descriptive cross-sectional study was done over a period of 6 months among 350 systematically randomly selected adult HIV-positive patients. PHQ-9 was used to obtain information on depression and the CD4 count was determined using a flow-cytometric method. Data were obtained and analyzed using SPSS-17. Chi-square was used to determine degree of association between the depression and the level of CD4 count. P-value of < 0.05 was considered statistically significant.Results: The prevalence of depression among the respondents was 33.4%. The prevalence of depression was highest among respondents with low CD4 count (≤349cells/ul), 37.0%, and least among those with high CD4 count (≥500cells/ul), 28.3%. This relationship was however not statistically significant.Conclusion: The overall prevalence of depression was high among the respondents (33.4%) suggesting the need for routine depression screening among HIV positive patients. There was no statistically significant association between presence of depression and level of CD4 count (p-value=0.302). Keywords: Depression, CD4count, PLWHA, Family Medicine, UITH.


2021 ◽  
Author(s):  
Kingsley Kamvuma ◽  
Yusuf ademola ◽  
Warren Chanda ◽  
Christopher Newton Phiri ◽  
Sam Bezza Phiri ◽  
...  

Abstract Background: Human immunodeficiency virus (HIV) and M.tuberculosis are two intracellular pathogens that interact at the cellular, clinical and population levels. Since the recognition of AIDS in 1981, the number of reported cases of TB in the has increased substantially, especially in regions with high incidence of AIDS. The main aim of this study was to establish weather there is a relationship between sputum smear positives and low CD4 cell counts among HIV infected patients.Materials and methods: This was a retrospective study involving 473 participants. The patients recruited in this study were those who tested HIV positive and smear positive for TB. Their HIV status was determined by performing an HIV blood test, if they were HIV positive their CD4 cell count were then made.Results: This study examined the relation between smear positivity and low CD4 (below 200cells/µl) together with CD8 and CD3 markers as a measure of immune function among patients infected with HIV. The study participants’ constituted males 67% and females 33%. The overall mean age was 33.2 (SD 6.9) with the youngest and oldest participants being 18 and 60 respectively. It was found that smear positive results negatively (r=-0.13; p=0.021) correlated with CD4+ below 200 cells/µl. No correlation was observed between smear positives and CD8+ or CD3+ since the calculated correlation coefficient was not significant 0.007 (p=0.9) and 0.03 (p=0.6) respectively. There are more 3+ smear results below 200 cells/µl than the others while above 200 cells/µl 1+ was the most commonly reported smear result. The scanty smear positives were the least commonly reported result in the low and high CD4 counts. Conclusion: The smear positive result negatively correlated with a low CD4+ (r=-0.13; p=0.021) but no correlation with low CD+8 and CD+3 results was observed. The long held theory that low bacillary counts in patients with low CD4+ counts needs to be revisited. The reduction of CD4+ cell count parallels' that of the total lymphocyte count and is more marked in patients with high bacillary counts. Further, studies are required to confirm these findings


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