Abstract
PURPOSE: After the initiation of highly active antiretroviral therapy (HAART), successful HAART is characterized by an increase in the CD4(+) count. Several factors affect the CD4(+) T-cell count. This study aimed to assess the immunological response during HAART and determinants of the current CD4(+) T-cell count among HIV/AIDS patients on HAART. PATIENTS AND METHODS: A hospital-based cross-sectional study was conducted from February 1 to April 1, 2017. A total of 423 HIV/AIDS patients on HAART were enrolled using simple random sampling. Descriptive statistics, and bivariate and multiple regression analyses were conducted. Variables with p-value <0.2 in the bivariate analysis were entered in the multiple regression models. p-Values <0.05 and 95% confidence intervals were used to identify determinants of the current CD4(+) T-cell count. RESULTS: The mean CD4(+) T-cell count gradually increased until 8 years on HAART but declined thereafter. An increased current CD4(+) T-cell count was observed among patients with an initial regimen of pediatric d4T-3TC-NVP [β=185.5, 95% CI (8.8, 362.2)] (p=0.040), with increased baseline CD4(+) T-cell count [β=0.468, 95% CI (0.342, 0.594)] (p<0.0001), and with long duration on HAART [β=18.0, 95% CI (9.9, 26.1)] (p<0.0001), whereas a decreased level of current CD4(+) T-cell count was observed among males [β=-72.7, 95% CI (-114.5, -30.9)]) (p<0.0001) and those with poor baseline adherence [β=-108.9, 95% CI (-210.9, -7.0)] (p=0.036) and viral load >1000 copies [β=-189.2, 95% CI (-243.5, -134.9)] (p<0.0001). CONCLUSION: The trend in immunological response was not increased linearly throughout the HAART duration. Sex, type of initial regimen, baseline adherence, baseline CD4(+) count, viral load, and duration on HAART were independent determinants of current CD4(+) count. These determinants could be addressed by regular monitoring of HIV patients on HAART, and special attention should be paid to male patients.