Factors Associated with Baseline CD4 Cell Counts and Advanced HIV Disease among Male and Female HIV-Positive Patients in Iran: A Retrospective Cohort Study

Despite the recommendation for early diagnosis and rapid initiation of HIV treatment, more than half of patients are in an advanced stage of HIV disease in Iran. This study aimed to investigate the factors related to baseline CD4 cell count and advanced HIV disease (AHD) in Southern Iran. The study...

Full description

Saved in:
Bibliographic Details
Main Authors: Sima Afrashteh, Mohammad Fararouei, Haleh Ghaem, Mohammad Aryaie
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Tropical Medicine
Online Access:http://dx.doi.org/10.1155/2022/8423347
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849400602151354368
author Sima Afrashteh
Mohammad Fararouei
Haleh Ghaem
Mohammad Aryaie
author_facet Sima Afrashteh
Mohammad Fararouei
Haleh Ghaem
Mohammad Aryaie
author_sort Sima Afrashteh
collection DOAJ
description Despite the recommendation for early diagnosis and rapid initiation of HIV treatment, more than half of patients are in an advanced stage of HIV disease in Iran. This study aimed to investigate the factors related to baseline CD4 cell count and advanced HIV disease (AHD) in Southern Iran. The study comprised all adults between 15 and 87 years of age who were newly diagnosed with HIV in Southern Iran. Linear and logistic regressions were used to identify baseline CD4 cell count predictors and AHD, respectively. A total of 820 (53.9%) HIV-infected individuals over 15 years of age were at the AHD stage. Based on the results of the multiple logistic regression, older age at diagnosis (OR≥40/<30 = 2.68, 95% CI = 1.38–5.19), gender (ORfemale/male = 0.62, 95% CI = 0.44–0.85), HIV/TB coinfection (ORyes/no = 1.98, 95% CI = 1.29–3.02), HIV/HBV coinfection (ORyes/no = 1.58, 95% CI = 1.07–2.38), and hemoglobin (OR = 0.89, 95% CI = 0.85–0.92) were directly associated with AHD in HIV/AIDS patients. As suggested by a linear regression model, factors including gender (B Female = 44.12, 95% CI:17.86, 70.38), older age (B ≥ 40 = −111.99, 95% CI:−174.70, −49.27), higher education level (B = 35.65, 95% CI:5.34, 65.97), WHO clinical stage (BIV = −254.53, 95% CI−298.82, −210.24), and hemoglobin (B = 5.23, 95% CI:0.25, 10.20) were significantly associated with CD4 count.The prevalence of AHD in patients was high in Iran. Our results suggested that several demographic and clinical factors are significantly associated with the baseline CD4 cell count and AHD. Targeted HIV testing, implementation of screening programs for early detection, and access to care services to assure early ART are recommended to improve the clinical status and quality of life of the patients.
format Article
id doaj-art-8e10135fb75149b4b3ad0636b282aa6a
institution Kabale University
issn 1687-9694
language English
publishDate 2022-01-01
publisher Wiley
record_format Article
series Journal of Tropical Medicine
spelling doaj-art-8e10135fb75149b4b3ad0636b282aa6a2025-08-20T03:37:57ZengWileyJournal of Tropical Medicine1687-96942022-01-01202210.1155/2022/8423347Factors Associated with Baseline CD4 Cell Counts and Advanced HIV Disease among Male and Female HIV-Positive Patients in Iran: A Retrospective Cohort StudySima Afrashteh0Mohammad Fararouei1Haleh Ghaem2Mohammad Aryaie3Student Research CommitteeHIV/AIDs Research CenterNon-Communicable Diseases Research CenterDepartment of EpidemiologyDespite the recommendation for early diagnosis and rapid initiation of HIV treatment, more than half of patients are in an advanced stage of HIV disease in Iran. This study aimed to investigate the factors related to baseline CD4 cell count and advanced HIV disease (AHD) in Southern Iran. The study comprised all adults between 15 and 87 years of age who were newly diagnosed with HIV in Southern Iran. Linear and logistic regressions were used to identify baseline CD4 cell count predictors and AHD, respectively. A total of 820 (53.9%) HIV-infected individuals over 15 years of age were at the AHD stage. Based on the results of the multiple logistic regression, older age at diagnosis (OR≥40/<30 = 2.68, 95% CI = 1.38–5.19), gender (ORfemale/male = 0.62, 95% CI = 0.44–0.85), HIV/TB coinfection (ORyes/no = 1.98, 95% CI = 1.29–3.02), HIV/HBV coinfection (ORyes/no = 1.58, 95% CI = 1.07–2.38), and hemoglobin (OR = 0.89, 95% CI = 0.85–0.92) were directly associated with AHD in HIV/AIDS patients. As suggested by a linear regression model, factors including gender (B Female = 44.12, 95% CI:17.86, 70.38), older age (B ≥ 40 = −111.99, 95% CI:−174.70, −49.27), higher education level (B = 35.65, 95% CI:5.34, 65.97), WHO clinical stage (BIV = −254.53, 95% CI−298.82, −210.24), and hemoglobin (B = 5.23, 95% CI:0.25, 10.20) were significantly associated with CD4 count.The prevalence of AHD in patients was high in Iran. Our results suggested that several demographic and clinical factors are significantly associated with the baseline CD4 cell count and AHD. Targeted HIV testing, implementation of screening programs for early detection, and access to care services to assure early ART are recommended to improve the clinical status and quality of life of the patients.http://dx.doi.org/10.1155/2022/8423347
spellingShingle Sima Afrashteh
Mohammad Fararouei
Haleh Ghaem
Mohammad Aryaie
Factors Associated with Baseline CD4 Cell Counts and Advanced HIV Disease among Male and Female HIV-Positive Patients in Iran: A Retrospective Cohort Study
Journal of Tropical Medicine
title Factors Associated with Baseline CD4 Cell Counts and Advanced HIV Disease among Male and Female HIV-Positive Patients in Iran: A Retrospective Cohort Study
title_full Factors Associated with Baseline CD4 Cell Counts and Advanced HIV Disease among Male and Female HIV-Positive Patients in Iran: A Retrospective Cohort Study
title_fullStr Factors Associated with Baseline CD4 Cell Counts and Advanced HIV Disease among Male and Female HIV-Positive Patients in Iran: A Retrospective Cohort Study
title_full_unstemmed Factors Associated with Baseline CD4 Cell Counts and Advanced HIV Disease among Male and Female HIV-Positive Patients in Iran: A Retrospective Cohort Study
title_short Factors Associated with Baseline CD4 Cell Counts and Advanced HIV Disease among Male and Female HIV-Positive Patients in Iran: A Retrospective Cohort Study
title_sort factors associated with baseline cd4 cell counts and advanced hiv disease among male and female hiv positive patients in iran a retrospective cohort study
url http://dx.doi.org/10.1155/2022/8423347
work_keys_str_mv AT simaafrashteh factorsassociatedwithbaselinecd4cellcountsandadvancedhivdiseaseamongmaleandfemalehivpositivepatientsiniranaretrospectivecohortstudy
AT mohammadfararouei factorsassociatedwithbaselinecd4cellcountsandadvancedhivdiseaseamongmaleandfemalehivpositivepatientsiniranaretrospectivecohortstudy
AT halehghaem factorsassociatedwithbaselinecd4cellcountsandadvancedhivdiseaseamongmaleandfemalehivpositivepatientsiniranaretrospectivecohortstudy
AT mohammadaryaie factorsassociatedwithbaselinecd4cellcountsandadvancedhivdiseaseamongmaleandfemalehivpositivepatientsiniranaretrospectivecohortstudy