scholarly journals Determinants of CD4 cell count change and time-to default from HAART; a comparison of separate and joint models

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Awoke Seyoum Tegegne ◽  
Principal Ndlovu ◽  
Temesgen Zewotir
Keyword(s):  
Cell Count ◽  
Joint Models ◽  
Cd4 Cell Count ◽  
Cd4 Cell ◽  
Count Change ◽  
Cd4 Cell Count Change

scholarly journals Assessment of Casual Relations, Direct and Indirect Effects of Latent Covariates On CD4 Cell Count Change Among HIV Positive Adults

2021 ◽  
Author(s):  
Awoke Seyoum Tegegne
Keyword(s):  
Cell Count ◽  
Indirect Effect ◽  
Latent Variables ◽  
Hiv Positive ◽  
Health Staff ◽  
Cd4 Cell Count ◽  
Hiv Positive Adults ◽  
Cd4 Cell ◽  
Count Change ◽  
Cd4 Cell Count Change

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.

scholarly journals Socio-Demographic and Clinical Predictor Variables on CD4 Cell Count Change among HIV Positive adults; a Structural Equations Modelling

2020 ◽  
Author(s):  
Awoke Seyoum ◽  
Principal Ndlovu Ndlovu ◽  
Temesgen Zewotire Zewotire
Keyword(s):  
Cell Count ◽  
Structural Equation ◽  
Structural Equations ◽  
Equation Modeling ◽  
Hiv Positive ◽  
Cd4 Cell Count ◽  
Hiv Positive Adults ◽  
Cd4 Cell ◽  
Count Change ◽  
Cd4 Cell Count Change

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

scholarly journals Structural Equation Modeling to Detect Predictors of CD4 Cell Count Change due to Long Term Antiretroviral Therapy Administered to HIV-Positive Adults at Felege Hiwot Teaching and Specialized Hospital, Bahir Dar, Ethiopia

2020 ◽  
Vol 2 (2) ◽  
pp. 15-27
Author(s):  
Awoke Seyoum Tegegne
Keyword(s):  
Structural Equation Modeling ◽  
Cell Count ◽  
Structural Equation ◽  
Equation Modeling ◽  
Cd4 Cell Count ◽  
Fit Index ◽  
Cd4 Cell ◽  
Count Change ◽  
Cd4 Cell Count Change ◽  
Hiv Aids

Background The relationship between predictors and the variable of interest was estimated using a structural equation model which is used to predict latent variables. The main advantage of the SEM is the ability to estimate the direct and indirect pathways of the effect of the primary independent variable on the outcome, given sufficient sample sizes. Despite not directly modeling the mediated pathways, GLMMs excluding mediating variables performed well with respect to power, bias and coverage probability in modeling the total effect of the primary independent variables on the outcome. In longitudinal studies, data are collected from subjects at several time points. The main purpose of longitudinal analysis is to detecting the trends or trajectories of the variables of interest. Methods A longitudinal study was conducted on 792 adults living with HIV/AIDS who commenced HAART. Structural equation modeling was used to construct a model to detecting predictors of CD4 cell count change. The procedure was illustrated by applying it to longitudinal health-related quality-of-life data on HIV/AIDS patients, collected from September 2008 to August 2012 monthly for the first six months and quarterly for remaining study period. Results The result of current investigation indicates that CD4 cell count change was highly influenced by certain socio-demographic and clinical variables. Out of all the participants, 141 (82%) have been considered 100% adherent to antiretroviral therapy. Structural equation modeling has confirmed the direct effect that personality (decision-making and tolerance of frustration) has on motives to behave, or act accordingly, which was in turn directly related to medication adherence behaviors. In addition, these behaviors have had a direct and significant effect on viral load, as well as an indirect effect on CD4 cell count. The final model demonstrates the congruence between theory and data (x2/df. = 1.480, goodness of fit index = 0.97, adjusted goodness of fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.05), accounting for 55.7% of the variance. Conclusions The results of this study support our theoretical model as a conceptual framework for the prediction of medication adherence behaviors in persons living with HIV/AIDS. Implications for designing, implementing, and evaluating intervention programs based on the model are to be discussed.

scholarly journals Joint Modeling in Detecting Predictors of Cd4 Cell Count and Status of Tuberculosis Among HIV Infected Patients Under HAART at Felege Hiwot Teaching and Specialized Hospital, North-west Ethiopia

2020 ◽  
Author(s):  
Setegn Byabil Agegn ◽  
Awoke seyoum Tegegn
Keyword(s):  
Cell Count ◽  
Joint Modeling ◽  
Joint Analysis ◽  
Joint Models ◽  
Expected Number ◽  
Hiv Patients ◽  
Cd4 Cell Count ◽  
North West ◽  
Specialized Hospital ◽  
Cd4 Cell

Abstract Background: Globally, the number of TB patients who had been diagnosed with HIV status reached 2.1 million, which is equivalent to 34 % of notified cases of TB. This research was conducted with the objective to identify potential predictors for the status of TB and CD4 cell count for adult HIV patients at Felege Hiwot Teaching and Specialized Hospital North-west Ethiopia.Methods: A retrospective repeated measures were taken from a sample of 226 HIV patients. Separate and joint models were conducted for data analysis of CD4 cell count and TB status of HIV infected patients. Results: The descriptive statistics indicates that among the HIV patients under HAART, 26.6% had additional TB cases. Hence, the expected number of CD4 cell count of HIV patients who were co-infected with TB was decreased by 2.34 as compared to HIV patients who were free from TB. In joint analysis, age, opportunistic infectious disease, adherence to medication, body mass index and social supports were significantly associated with CD4 cell count and TB status. In addition, one-way interaction terms (time * educational level) was also associated with both outcomes. As patients’ age increased by one year, the expected number of CD4 cell count was decreased by 0.025 cells per/mm3 keeping the other variables constant. The expected number of CD4 cell count for patients whose status were ambulatory was decreased by 3.95 as compared to working status. Both separate and joint modeling approach revealed consistent results for significant predictors. However, joint models were more adequate and efficient. Conclusions: Among the predictors of CD4 cell count and TB status, WHO stages, age of patients, functional status of patients, hemoglobin level and residence area were significant predictors for the variable of interests. More attention should be given for HIV/TB co- infected ambulatory and bedridden patients.

scholarly journals The Role of Aerosol Pentamidine Prophylaxis

1993 ◽  
Vol 4 (2) ◽  
pp. 67-69
Author(s):  
E L C Ong
Keyword(s):  
Cell Count ◽  
Pneumocystis Carinii Pneumonia ◽  
Lymphocyte Count ◽  
Pneumocystis Carinii ◽  
Total Lymphocyte Count ◽  
First Episode ◽  
Cd4 Cell Count ◽  
Drug Of Choice ◽  
Cd4 Cell

Pneumocystis carinii pneumonia (PCP) is the most frequent opportunistic infection in patients with AIDS, occurring in 80% and recurring in 50% of patients within 12 months of the first episode. Prophylaxis for PCP is recommended if the CD4+ cell count is <200×106/l or 20% of the total lymphocyte count, or after an episode of PCP. The most effective prophylactic agent currently is trimethoprim-sulphamethoxazole and should be the drug of choice but alternatives such as aerosol pentamidine are being increasingly used for patients who cannot tolerate this combination or other oral preparations. If aerosol pentamidine is used and administered via a Respigard II Marquest nebulizer, the dosage should be higher than the currently recommended monthly dosage of 300 mg.

scholarly journals Frequency of Cytomegalovirus Viral Load in Iranian Human Immunodeficiency Virus-1-Infected Patients with CD4+ Counts <100 Cells/mm3

Intervirology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Mohammad Reza Jabbari ◽  
Hoorieh Soleimanjahi ◽  
Somayeh Shatizadeh Malekshahi ◽  
Mohammad Gholami ◽  
Leila Sadeghi ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Cell Count ◽  
Previous History ◽  
Cd4 Count ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Immunodeficiency Virus ◽  
Cd4 Cell ◽  
Hiv 1

<b><i>Objectives:</i></b> The aim of present work was to assess cytomegalovirus (CMV) viremia in Iranian human immunodeficiency virus (HIV)-1-infected patients with a CD4+ count &#x3c;100 cells/mm<sup>3</sup> and to explore whether CMV DNA loads correlate with CD4+ cell counts or associated retinitis. <b><i>Methods:</i></b> This study was conducted at the AIDS research center in Iran on HIV-1-infected patients with CD4+ count &#x3c;100 cells/mm<sup>3</sup>, antiretroviral therapy-naive, aged ≥18 years with no previous history of CMV end-organ disease (CMV-EOD). <b><i>Results:</i></b> Thirty-nine of 82 patients (47.56%) had detectable CMV viral load ranging from 66 to 485,500 IU/mL. CMV viral load in patients with retinitis ranges from 352 to 2,720 IU/mL, and it was undetectable in 2 patients. No significant associations between CMV viremia and CD4+ cell count was found (<i>p</i> value = 0.31), whereas significant association of CMV viremia in HIV-infected patients with retinitis was found (<i>p</i> &#x3c; 0.02). <b><i>Conclusions:</i></b> We estimated the frequency of CMV viral load infection in Iranian HIV-1-infected patients with a CD4+ cell count &#x3c;100 mm<sup>3</sup>/mL in the largest national referral center for HIV-1 infection in Iran. Further research is required on the relevance of CMV viral load in diagnostic and prognostic value of CMV-EOD.

330 CHARACTERISTICS OF NOT KNOWING THE CD4 CELL COUNT WHEN LIVING WITH HIV.

2006 ◽  
Vol 54 (1) ◽  
pp. S315.3-S315
Author(s):  
A.R Hoellein ◽  
J. A. Kendall ◽  
J. F. Wilson ◽  
A. C. Thornton
Keyword(s):  
Cell Count ◽  
Cd4 Cell Count ◽  
Living With Hiv ◽  
Cd4 Cell
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