CD4+ cells recovery in HIV positive patients with severe immunosuppression at HAART initiation at Centre Medico-Social Cor-Unum, Kigali

Pan Afr Med J. 2017 Jan 12:26:14. doi: 10.11604/pamj.2017.26.14.10488. eCollection 2017.

Abstract

Introduction: Up to 30% of HIV infected patients who are receiving HAART do not exhibit a marked increase in the CD4+ T cell count. There is still a concern that immune recovery may not be complete once CD4+ T cells have decreased below 200 cells/μl. The objective is to assess CD4+ cell recovery in HIV+ patients with CD4 count below 200 cells/μl) at HAART initiation.

Methods: This was a retrospective cohort study among 110 HIV+ patients with initial CD4 count < 200 cells/μl. Baseline Age, sex, CD4 count and viral load were extracted from the patient's database. After12 months of HAART; CD4 count was done using flow cytometry and viremia by COBAS AmpliPrep/COBAS TaqMan HIV-1 test v 2.0 technology.

Results: The mean age of the respondents was 35 years; males being 57% and females were 43%. The mean CD4 count before HAART was 110.18 cells/μl whereas at 12 months of HAART; this was 305.01 cells/μl. Though some patients did not achieve a CD4 count of more than 200 cells/μl or a drop in viral load; there was a significant recovery of CD4+ cells (P value=0.000) and viremia following HAART (P value=0.001). Participants aged 18-30 years were likely to have less than 200 cells/μl CD4 count (46.4%) [OR=4.33; 95%CI: 1.29-14.59; P=0.018] than participants aged above 40 years (16.7%).

Conclusion: HAART was associated with viremia suppression but many patients failed to achieve a CD4 count >200 cells/μl. HAART before severe immunosuppression is a key factor for immune restoration among HIV+ patients.

Keywords: CD4+ cells; HAART; immune recovery; severe immunosuppression; viremia.

MeSH terms

  • Adolescent
  • Adult
  • Antiretroviral Therapy, Highly Active / methods
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes / immunology*
  • Cohort Studies
  • Female
  • Flow Cytometry
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • Humans
  • Immunocompromised Host / immunology*
  • Male
  • Retrospective Studies
  • Rwanda
  • Viral Load / drug effects
  • Viremia / drug therapy*
  • Young Adult