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Background: As one of the countries in the Sub-Saharan African Region, Ethiopia also happens to bear a higher burden of HIV infection. For HIV-infected patients, the level of CD4 count remains an important test with regard to diagnostic decision-making. There is limited information on predictors of longitudinal change in CD4 count over time that examine immunologic response of patients during the course of treatment in Ethiopia. Therefore, this study aimed to examine predictors of change in CD4 count among adult HIV infected patients on antiretroviral treatment in west Hararghe zone, Ethiopia. Methods: An institutional based retrospective cohort study was conducted among 405 adult HIV/AIDS patients on Anti-Retro Viral Therapy (ART) from September 2013 to January 2019. Data was entered into Epi info 7 and analyzed in R software. Generalized mixed effect model was applied to identify predictors of longitudinal change in CD4 count. Results: In multivariable analysis time since start of ART (beta=0.306, 95%CI, 0.286: 0.326), primary level educational status (beta=0.048, 95%CI, 0.004: 0.092), tertiary educational status (beta=0.094, 95%CI, 0.007: 0.182), WHO RVI stage II (beta=-0.108, 95%CI, -0.156:-0.061), bedridden functional status (beta=-0.175, 95%CI,-0.309:-0.039), poor baseline adherence (beta=-0.145, 95%CI, -0.214: -0.076) and baseline weight (beta=-0.004, 95%CI, -0.006, -0.002) were significant predictors of longitudinal CD4 change. Conclusion: In this study time since start of ART, primary and tertiary educational status contributed positively to the change in CD4 count whereas bedridden functional status, poor adherence, WHO RVI stage II and baseline weight are negatively associated with longitudinal change in CD4 count. Close monitoring for bedridden patients and patients with poor baseline adherence is needed especially during the initiation of ART for immunological response.

international journal of hiv/aids prevention, education and behavioural science

Predictors of Change in CD4 Count among Adult HIV/AIDS Patients on Anti-Retroviral Treatment in West Hararghe Zone, Ethiopia; Retrospective Longitudinal Study