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Trends of Immuno-virological Response Among HIV-Infected Patients Receiving Highly Active Anti-retroviral Therapy at Hawassa, Southern Ethiopia

Received: 01 June 2015    Accepted: 11 June 2015    Published: 29 June 2015
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Abstract

Background: Immunological and virological response evaluation is one of a critical tool for assessing treatment outcome, regimen change and patient’s management. However, data concerning any change in immunological and virological response in HIV infected patients using anti-retroviral treatment (ART) is scarce in Ethiopia. Method: This retrospective cohort study was conducted from April 2010–September 2013 at ART clinic of Hawassa University referral hospital. A total of 86 HIV-infected patients receiving Tenofovir, Stavudine and Zidovudine based regimen with either of Efavirenz or Nevirapine during ART initiation. Lamivudine is common for all. Adequate immuno-virological response for most patients under treatment is defined as an increase in CD4 cells of 50–150/µl per year and viral load (VL) drops to undetectable level (<150 copies/ml) after ≥ 6 months of ART. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) Version 20. Results: mean CD4+ cells count shows significant increment at 6, 12, 18 and 24 months after ART treatment among patients having VL <5 (log10) compared to those VL ≥5 (p=0.04; 0.002; < 0.0001; 0.001) respectively. Females have insignificantly better Mean CD4+ cells throughout 24 months. Also patients over 50 years of age do show an immune response after ART initiation. But, in relative to younger patients, their CD4 cells recovery is insignificantly sluggish. CD4+ cells and body weight of concordant positive responders show significant rising trend at 6, 12, 18, 24 months when compared to discordant responders + concordant non-responders, and p-value: (0.003 vs. 0.05; <0.0001 vs. 0.04; 0.001 vs.0.008; 0.001 vs.0.03) respectively. Moreover logistic regression models were applied and significant factors associated with discordant immuno-virological response were patient’s body weight (AOR=0.14; 95% CI: 0.03-0.7; p=0.02) and residence (AOR=20.3; 95% CI: 2.2-188; p=0.008). Conclusion: Immuno-virological response assessment is a critical tool for addressing treatment outcome, regimen change and patient’s management for those peoples living with HIV using ART. Therefore we recommend that treatment response decision should include both CD4+ cells count and viral load concurrently.

DOI 10.11648/j.cmr.20150404.13
Published in Clinical Medicine Research (Volume 4, Issue 4, July 2015)
Page(s) 104-110
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Immuno-virological Response, ART, HIV, Hawassa, Ethiopia

References
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Author Information
  • Hawassa University, college of Medicine and Health Sciences, Department of Medical Laboratory Science, Hawassa, Southern Ethiopia

  • Hawassa University, college of Medicine and Health Sciences, Department of Medical Laboratory Science, Hawassa, Southern Ethiopia

  • Hawassa University, college of Medicine and Health Sciences, Referral Hospital, Hawassa, Southern Ethiopia

  • Hawassa University, college of Medicine and Health Sciences, Referral Hospital, Hawassa, Southern Ethiopia

  • Hawassa University, college of Medicine and Health Sciences, Referral Hospital, Hawassa, Southern Ethiopia

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    Agete Tadewos Hirigo, Demissie Assegu Fenta, Tadewos Beyene Bala, Selamawit Gutema Bule, Meseret Regassa Gemechu. (2015). Trends of Immuno-virological Response Among HIV-Infected Patients Receiving Highly Active Anti-retroviral Therapy at Hawassa, Southern Ethiopia. Clinical Medicine Research, 4(4), 104-110. https://doi.org/10.11648/j.cmr.20150404.13

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    Agete Tadewos Hirigo; Demissie Assegu Fenta; Tadewos Beyene Bala; Selamawit Gutema Bule; Meseret Regassa Gemechu. Trends of Immuno-virological Response Among HIV-Infected Patients Receiving Highly Active Anti-retroviral Therapy at Hawassa, Southern Ethiopia. Clin. Med. Res. 2015, 4(4), 104-110. doi: 10.11648/j.cmr.20150404.13

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    AMA Style

    Agete Tadewos Hirigo, Demissie Assegu Fenta, Tadewos Beyene Bala, Selamawit Gutema Bule, Meseret Regassa Gemechu. Trends of Immuno-virological Response Among HIV-Infected Patients Receiving Highly Active Anti-retroviral Therapy at Hawassa, Southern Ethiopia. Clin Med Res. 2015;4(4):104-110. doi: 10.11648/j.cmr.20150404.13

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  • @article{10.11648/j.cmr.20150404.13,
      author = {Agete Tadewos Hirigo and Demissie Assegu Fenta and Tadewos Beyene Bala and Selamawit Gutema Bule and Meseret Regassa Gemechu},
      title = {Trends of Immuno-virological Response Among HIV-Infected Patients Receiving Highly Active Anti-retroviral Therapy at Hawassa, Southern Ethiopia},
      journal = {Clinical Medicine Research},
      volume = {4},
      number = {4},
      pages = {104-110},
      doi = {10.11648/j.cmr.20150404.13},
      url = {https://doi.org/10.11648/j.cmr.20150404.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.cmr.20150404.13},
      abstract = {Background: Immunological and virological response evaluation is one of a critical tool for assessing treatment outcome, regimen change and patient’s management. However, data concerning any change in immunological and virological response in HIV infected patients using anti-retroviral treatment (ART) is scarce in Ethiopia. Method: This retrospective cohort study was conducted from April 2010–September 2013 at ART clinic of Hawassa University referral hospital. A total of 86 HIV-infected patients receiving Tenofovir, Stavudine and Zidovudine based regimen with either of Efavirenz or Nevirapine during ART initiation. Lamivudine is common for all. Adequate immuno-virological response for most patients under treatment is defined as an increase in CD4 cells of 50–150/µl per year and viral load (VL) drops to undetectable level (<150 copies/ml) after ≥ 6 months of ART. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) Version 20. Results: mean CD4+ cells count shows significant increment at 6, 12, 18 and 24 months after ART treatment among patients having VL <5 (log10) compared to those VL ≥5 (p=0.04; 0.002; < 0.0001; 0.001) respectively. Females have insignificantly better Mean CD4+ cells throughout 24 months. Also patients over 50 years of age do show an immune response after ART initiation. But, in relative to younger patients, their CD4 cells recovery is insignificantly sluggish. CD4+ cells and body weight of concordant positive responders show significant rising trend at 6, 12, 18, 24 months when compared to discordant responders + concordant non-responders, and p-value: (0.003 vs. 0.05; <0.0001 vs. 0.04; 0.001 vs.0.008; 0.001 vs.0.03) respectively. Moreover logistic regression models were applied and significant factors associated with discordant immuno-virological response were patient’s body weight (AOR=0.14; 95% CI: 0.03-0.7; p=0.02) and residence (AOR=20.3; 95% CI: 2.2-188; p=0.008). Conclusion: Immuno-virological response assessment is a critical tool for addressing treatment outcome, regimen change and patient’s management for those peoples living with HIV using ART. Therefore we recommend that treatment response decision should include both CD4+ cells count and viral load concurrently.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Trends of Immuno-virological Response Among HIV-Infected Patients Receiving Highly Active Anti-retroviral Therapy at Hawassa, Southern Ethiopia
    AU  - Agete Tadewos Hirigo
    AU  - Demissie Assegu Fenta
    AU  - Tadewos Beyene Bala
    AU  - Selamawit Gutema Bule
    AU  - Meseret Regassa Gemechu
    Y1  - 2015/06/29
    PY  - 2015
    N1  - https://doi.org/10.11648/j.cmr.20150404.13
    DO  - 10.11648/j.cmr.20150404.13
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 104
    EP  - 110
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20150404.13
    AB  - Background: Immunological and virological response evaluation is one of a critical tool for assessing treatment outcome, regimen change and patient’s management. However, data concerning any change in immunological and virological response in HIV infected patients using anti-retroviral treatment (ART) is scarce in Ethiopia. Method: This retrospective cohort study was conducted from April 2010–September 2013 at ART clinic of Hawassa University referral hospital. A total of 86 HIV-infected patients receiving Tenofovir, Stavudine and Zidovudine based regimen with either of Efavirenz or Nevirapine during ART initiation. Lamivudine is common for all. Adequate immuno-virological response for most patients under treatment is defined as an increase in CD4 cells of 50–150/µl per year and viral load (VL) drops to undetectable level (<150 copies/ml) after ≥ 6 months of ART. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) Version 20. Results: mean CD4+ cells count shows significant increment at 6, 12, 18 and 24 months after ART treatment among patients having VL <5 (log10) compared to those VL ≥5 (p=0.04; 0.002; < 0.0001; 0.001) respectively. Females have insignificantly better Mean CD4+ cells throughout 24 months. Also patients over 50 years of age do show an immune response after ART initiation. But, in relative to younger patients, their CD4 cells recovery is insignificantly sluggish. CD4+ cells and body weight of concordant positive responders show significant rising trend at 6, 12, 18, 24 months when compared to discordant responders + concordant non-responders, and p-value: (0.003 vs. 0.05; <0.0001 vs. 0.04; 0.001 vs.0.008; 0.001 vs.0.03) respectively. Moreover logistic regression models were applied and significant factors associated with discordant immuno-virological response were patient’s body weight (AOR=0.14; 95% CI: 0.03-0.7; p=0.02) and residence (AOR=20.3; 95% CI: 2.2-188; p=0.008). Conclusion: Immuno-virological response assessment is a critical tool for addressing treatment outcome, regimen change and patient’s management for those peoples living with HIV using ART. Therefore we recommend that treatment response decision should include both CD4+ cells count and viral load concurrently.
    VL  - 4
    IS  - 4
    ER  - 

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