Immunological Response of Human Immunodeficiency Virus Positive Patients after Initiation of Highly Active Antiretroviral Therapy

Background: Effective care for people living with human immunodeficiency virus (PLHIV) requires highly active antiretroviral therapy (HAART). HAART mainly acts on suppression of viral replication and allows the recovery of patient's immune system protecting him/ her from the development of AIDS and death. Objective: The study aims to document the experience of immunological response among PLHIV on HAART comparing different categories of patients. Methods: This is a retrospective analytical quantitative study with a sample size of 224 patients who were started with HAART. A total of three CD4 counts were measured pre-therapy, 1st post therapy, and 2nd post therapy at 6 monthly intervals to determine the change in CD4 counts. The rates of CD4 change were also compared among the different categories of patients. Results: Men had higher CD4 count (mean of 96.4 cells) with mean age of participants being 37 years at baseline. The CD4 count increased from a mean baseline of 86.2 cells to 372.2, 390.0, respectively, at 6, 12, months of treatment (P < 0.001 at each time point). There was no gender (P = 0.46) and age (P = 0.96) differences in treatment response. There was no much difference (P = 0.18) in treatment response comparing those with CD4 < 200 and those with CD4 count > 200 at baseline although patients with baseline CD4 count < 200 cells showed larger increases after 12 months of treatment. The patients with pre-therapy CD4 count < 200 cells, 127 (81.4%) patients out of 156 were adherent, and 29 (18.6%) were non-adherents. Conclusion: Adherent patients with base line CD4 < 200 achieved greater improvement in their CD4 cell counts. A high level of adherence to HAART is required to achieve a significant improvement in CD4 cell counts (immunological improvement) among PLHIV.