CD4 cell count recovery among HIV-infected patients with very advanced immunodeficiency commencing antiretroviral treatment in sub-Saharan Africa

Sub-Saharan Africa (SSA) is facing a growing co-epidemic of chronic HIV infection and diabetes. Hemoglobin A1c (A1c) may underestimate glycemia among people living with HIV (PLWH). We estimated the validity of A1c to diagnose diabetes among PLWH and HIV-uninfected persons in rural Uganda. Data were derived from a cohort of PLWH and age- and gender-matched HIV-uninfected comparators. We compared A1c to fasting blood glucose (FBG) using Pearson correlations, regression models, and estimated the sensitivity and specificity of A1c for detecting diabetes with FBG ≥126 mg/dL as reference standard. Approximately half (48%) of the 212 participants were female, mean age of 51.7 years (SD = 7.0) at enrollment. All PLWH (n = 118) were on antiretroviral therapy for a median of 7.5 years with mean CD4 cell count of 442 cells/µL. Mean FBG (89.7 mg/dL) and A1c (5.6%) were not different between PLWH and HIV-uninfected ( P > 0.50) groups, but the HIV-uninfected group had a higher prevalence of A1c >5.7% (33% vs. 20%, P = 0.024). We found a relatively strong correlation between A1c and FBG (r = 0.67). An A1c ≥6.5% had a poor sensitivity (46%, 95% CI 26–67%) but high specificity (98%, 95% CI 96–99%) for detecting diabetes. More work is needed to define an optimal A1c for screening diabetes in SSA.

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CD4+ cell count recovery after combined antiretroviral therapy in the modern combined antiretroviral therapy era

AIDS ◽

10.1097/qad.0000000000002010 ◽

2018 ◽

Vol 32 (17) ◽

pp. 2605-2614 ◽

Cited By ~ 8

Author(s):

Hélène Roul ◽

Murielle Mary-Krause ◽

Jade Ghosn ◽

Constance Delaugerre ◽

Gilles Pialoux ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Cell Count ◽

Cd4 Cell Count ◽

Combined Antiretroviral Therapy ◽

Cd4 Cell ◽

Count Recovery

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Program-level and contextual-level determinants of low-median CD4+ cell count in cohorts of persons initiating ART in eight sub-Saharan African countries

AIDS ◽

10.1097/qad.0b013e32834811b2 ◽

2011 ◽

Vol 25 (12) ◽

pp. 1523-1533 ◽

Cited By ~ 43

Author(s):

Denis Nash ◽

Yingfeng Wu ◽

Batya Elul ◽

David Hoos ◽

Wafaa El Sadr

Keyword(s):

Cell Count ◽

African Countries ◽

Cd4 Cell Count ◽

Sub Saharan ◽

Cd4 Cell

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Structural barriers to antiretroviral treatment: a study using population-based CD4 cell count and linked antiretroviral treatment programme data

The Lancet ◽

10.1016/s0140-6736(13)62253-9 ◽

2013 ◽

Vol 382 ◽

pp. S5 ◽

Cited By ~ 6

Author(s):

Till Bärnighausen ◽

Frank Tanser ◽

Kobus Herbst ◽

Tinofa Mutevedzi ◽

Joël Mossong ◽

...

Keyword(s):

Cell Count ◽

Antiretroviral Treatment ◽

Population Based ◽

Treatment Programme ◽

Structural Barriers ◽

Cd4 Cell Count ◽

Cd4 Cell

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Effect of BMI and fat mass on HIV disease progression in HIV-infected, antiretroviral treatment-naïve adults in Botswana

British Journal Of Nutrition ◽

10.1017/s0007114516001409 ◽

2016 ◽

Vol 115 (12) ◽

pp. 2114-2121 ◽

Cited By ~ 7

Author(s):

S. S. Martinez ◽

A. Campa ◽

H. Bussmann ◽

S. Moyo ◽

J. Makhema ◽

...

Keyword(s):

Cell Count ◽

Disease Progression ◽

Fat Mass ◽

Antiretroviral Treatment ◽

Obesity Paradox ◽

Hiv Disease ◽

Time To Event ◽

Cd4 Cell Count ◽

Cd4 Cell

AbstractAn obesity paradox has been proposed in many conditions including HIV. Studies conducted to investigate obesity and its effect on HIV disease progression have been inconclusive and are lacking for African settings. This study investigated the relationship between overweight/obesity (BMI≥25 kg/m2) and HIV disease progression in HIV+ asymptomatic adults not on antiretroviral treatment (ART) in Botswana over 18 months. A cohort study in asymptomatic, ART-naïve, HIV+ adults included 217 participants, 139 with BMI of 18·0–24·9 kg/m2 and seventy-eight participants with BMI≥25 kg/m2. The primary outcome was time to event (≥25 % decrease in cluster of differentiation 4 (CD4) cell count) during 18 months of follow-up; secondary outcomes were time to event of CD4 cell count<250 cells/µl and AIDS-defining conditions. Proportional survival hazard models were used to compare hazard ratios (HR) on time to events of HIV disease progression over 18 months. Higher baseline BMI was associated with significantly lower risk of an AIDS-defining condition during the follow-up (HR 0·218; 95 % CI 0·068, 0·701; P=0·011). Higher fat mass at baseline was also significantly associated with decreased risk of AIDS-defining conditions during the follow-up (HR 0·855; 95 % CI 0·741, 0·987; P=0·033) and the combined outcome of having CD4 cell count≤250/µl and AIDS-defining conditions, whichever occurred earlier (HR 0·918; 95 % CI 0·847, 0·994; P=0·036). All models were adjusted for covariates. Higher BMI and fat mass among the HIV-infected, ART-naïve participants were associated with slower disease progression. Mechanistic research is needed to evaluate the association between BMI, fat mass and HIV disease progression.

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Multilevel model on longitudinal data analysis in determinants of cd4 cell count among antiretroviral therapy attendant of hiv infected adults follow up in gondar teaching referral hospital, Gonder, Ethiopia.

10.21203/rs.2.21931/v1 ◽

2020 ◽

Author(s):

Kindu Kebede

Keyword(s):

Antiretroviral Therapy ◽

Cell Count ◽

Multilevel Model ◽

Immune Cell ◽

Hemoglobin Level ◽

Referral Hospital ◽

Sub Saharan Africa ◽

Cd4 Cell Count ◽

Cd4 Cell

Abstract Background: Human immunodeficiency virus attacked an immune cell and the CD4 cell which is responsible for the body’s immune to infectious agents. Acquired immunodeficiency syndrome is one of the major public health problems in Sub-Saharan Africa including Ethiopia. The main objective of this study to identify the determinants of CD4 cell count among antiretroviral therapy attendants of infected adults follow up in Gonder teaching referral hospital, Gonder, Ethiopia implemented by SAS version 94. Methods: A retrospective cohort study was conducted on 216 regular follow up patients whose age greater than 14 years from December 1, 2012, to December 30, 2017. A multilevel model was used to identify the factors of CD4 cell count of patients and it considered variability between and within patients. Results: The mean with a standard deviation of weight, and a hemoglobin level of patients were 55.48(10.21), and 18.25(33.028) respectively. This study concluded that the variation for CD4 cell count existed between patients was 63 % and the remaining 37 % of variation existing within patients. In this study, the random coeﬃcient time-varying covariate model was well fitted which shows weight and hemoglobin level were statistically significant predictors at a 5% level of significance for the log of CD4 cell count of patients. Conclusion: This study shows the hemoglobin level and weight of patients were statistically significant for the log of CD4 cell count of patients follow up in Gonder teaching referral hospital, Gonder, Ethiopia. Moreover, the result of the study shows that the log of CD4 count of patients increased when hemoglobin level and weight of patients increased. Hence, intervention should be given the ways to increase weight and hemoglobin levels of patients during follow up antiretroviral therapy.

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