Immunological recovery time of adult AIDS patients on ART: A case study at Felege-Hiwot Referral Hospital, Bahir-Dar, Ethiopia

Background: Antiretroviral Treatment (ART) has improved the immunological recovery of HIV patients. However, the extent of immunological recovery over time is not easy to predict because it depends on a number of factors. Objectives: The purpose of this study was to estimate time to immunological recovery of AIDS patients under ART. Methods: A sample of 387 patients was taken from patients' records at Bahir-Dar Felege-Hiwot Referral Hospital from June 2006 to August 2013. The Kaplan-Meier method and Cox proportional hazard model were applied to describe and analyze the data. Results: Associated with a relatively short immunological recovery time were the categories: high CD4 count, weight 45kgs and higher, WHO stages I, II and III, and being non-anemic. The respective adjusted hazard ratios are: 1.11 for a 50 cells/mu l increase in the baseline CD4 count, 1.13 for a 5kgs increase of baseline weight, 1.88, 1.67, 1.64, respectively, for WHO stages I, II, III, and 1.34 for not-anemic patients. Associated with a delayed immunological recovery, on the other hand, were male gender, advanced age, total WBC count <1200, and regimen change. The adjusted hazard ratios are: 0.73 for males, 0.92 for a 5-years increase in age, 0.77 for patients with total WBC count <1200 cells/mm(3), 0.69 among patients who changed regimen. Conclusion: The major predictors of time to immunological recovery of HIV/AIDS patients were gender, age, anemia status, baseline CD4 count, baseline WBC count, baseline weight, baseline WHO stage and regimen change. Immunological recovery experience was found to be statistically not significant among groups classified by, marital status, knowledge of ART, residence, voluntary counseling and testing, educational level, regimen type, condom use, adherence to treatment, partner's HIV status, risk factors and functional status.