Comparison of clinical and laboratory profile of Haart adherent and non-adherent HIV/AIDS patients in Calabar, Nigeria

Abstract

Background: The burden of HIV/AIDS has reduced following sustained interventions especially with introduction of highly active antiretroviral therapy (HAART). HIV/AIDS has become a chronic condition for which adherence to therapy is of public health relevance. This study was aimed at assessing the relationship between adherence to HAART and clinical and laboratory outcomes in a tertiary centre.
Methodology: This was a cross-sectional descriptive study of three hundred and forty eight (348) respondents on HAART. Adherence was measured using an adapted adult AIDS clinical trial group (AACTG) with optimal adherence set at ≥95%. Clinical stage, anthropometry, CD4, total lymphocyte and haemoglobin were used to monitor clinical, immunological and haematological outcome of adherence.
Result: The mean (SD) age of respondents was 34.8 (5.3) years, ranging from 18 - 68 years, with male: female ratio of 1:1.7. Adherence to HAART was 89.1%.  Non-adherent compared with adherent respondents, had marginally significantly  higher proportion of WHO AIDS Stage 3 disease (44.7% vs. 26.4%, p=0.05).  Comparing baseline with current values, change in mean CD4 cell counts was  significantly higher among adherent compared with non-adherent respondents (187 vs. 125, p=0.00). Also, change in mean total lymphocyte counts was significantly higher among adherent compared with non-adherent respondents (508 vs. 314, p=0.00). Change in CD4 cell count significantly correlated with adherence (t=0.15, p<0.05).
Conclusion: Self-reported optimal adherence significantly correlated with  immunological recovery, which is a key determinant of good clinical outcome in HIV patients. Measures aimed at sustaining adherence to HAART, and regular  assessment of CD4 count should be strengthened.

Keywords: Adherence, CD4 count, Total lymphocyte count, Adult AIDS Clinical Trial Group