Trends of CD4 count after initiation of antiretroviral therapy and the predictors of immunological non response in HIV infected patients in a tertiary care centre of Southern Bengal
Journal Title: Journal of the Indian Medical Association - Year 2019, Vol 117, Issue 3
Abstract
This retrospective cross sectional study was done by reviewing the records of 422 patients of HIV (who received ART from the ART clinic of Midnapore Medical College) to assess the trends in CD4 cell recovery among HIV patients after initiation of ART, the effect of different baseline characteristics on CD4 cell count response & to find out predictors of immunological non response (Rise of CD4 counts of <50 cells/µl after first 12 months of ART). Relationship of different variables like baseline CD4 counts, age etc with immunological non response were also assessed. The overall median change from baseline to the 48 months CD4 count was +359 cells/µl. The median changes at 48 months were +216 cells/µl,+35cells/µl & +59 cells/µl in the strata of baseline CD4 of >350, 201-350 & <200 cells/µl respectively. CD4 counts almost returned to normal at the end of 48 months in those with initial CD4 counts of >350 cells/µl. The patients with a lower baseline CD4 had lower peak CD4 counts. Patients with lower CD4 counts at the beginning had subsequent poor CD4 recovery & higher chances of immunological non response as well. Female patients & patients of WHO clinical stage 4 was also found to be at significantly higher risk of immunological non response. Our findings suggest that HAART should be initiated early for better immune recovery & female patients should be given more consideration regarding adherence to the therapy.
Authors and Affiliations
Kripasindhu Gantait, Atanu Chandra, Puspendu Biswas, Indranil Sen, Rajat Goswami
Keywords
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