ART-naive HIV patients at Feleg-Hiwot Referral Hospital Northwest, Ethiopia

Abstract

Objectives: To determine socio-demographic and immunological status of anti-retroviral treatment (ART)-naïve HIVpositive patients.
Methods: This was a longitudinal survey of HIV-positive patients treated with ART at Felege-Hiwot Hospital. CD4 cell counts were enumerated at baseline and after 6 months of treatment using FACS count (Becton Dickinson). Socioeconomic data were collected using pre tested questionnaires.
Results: Three hundred sixty eight (62% female), with median age 30 years were enrolled. Of these, 207 (56.5%) were uneducated and 233 (66.8%) had monthly income ≤ 250 birr. Three hundred fifteen (85.6%) started ART within 6 months of HIV diagnosis. The mean (95% CI) CD4 cell count at baseline was 153 (139-167); 156 (137-175) for females and 122 cells/μl (105-139) for males (p<0.01). At baseline, 280 (76.3%) and 134 (36.4%) patients had CD4 cell count <200 and ≤ 100 cells/μl, respectively. Six months follow-up CD4 counts were enumerated for 225 (61%) patients and their mean CD4 cells increased from 143-261 cells/μl (p < 0.05) with a mean cell gain of 117 cells/μl. Of the 166 follow-up patients withCD4 count <200 cells/μl at baseline, 130 (78%) attained a higher CD4 cells count after treatment compared to 50 (85.6%) of the 59 with CD4 cell >200 cells/μl (p=0.21).
Conclusion: In this setting, HIV patients started ART with lower mean CD4 cell counts of 153 cells/μl and most patients with low baseline CD4 cells (<200 cells/μl) counts didn’t achieve an increase in the number of CD4 cells after treatment. The majority of ART-naïve HIV patients were from low levels of education and with minimum monthly income. Appropriate interventions should be implemented to promote and enable HIV positive individuals to enter into ART programs as early as possible [Ethiop. J. Health Dev 2010;24(1):3-8].