Determinants of immunological recovery following HAART among severely immunosuppressed patients at enrolment to care in Northern Ethiopia: a retrospective study
Objective This study aimed to identify determinants of immunological recovery following highly active antiretroviral therapy (HAART) among severely immunosuppressed patients at enrolment to care in Northern Ethiopia.Methods A retrospective study.Setting The study was done in Tigray Region, Northern...
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BMJ Publishing Group
2020-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/8/e038741.full |
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| author | Awtachew Berhe Woldu Abraham Aregay Desta Tewolde Wubayehu Woldearegay Kibriti Mehari Kidane Yemane Weldu Bahta Kiros Fenta Ajemu Ataklti Gebretsadik Woldegebriel Asfawosen Aregay Berhe Nega Mamo Bezabih |
| author_facet | Awtachew Berhe Woldu Abraham Aregay Desta Tewolde Wubayehu Woldearegay Kibriti Mehari Kidane Yemane Weldu Bahta Kiros Fenta Ajemu Ataklti Gebretsadik Woldegebriel Asfawosen Aregay Berhe Nega Mamo Bezabih |
| author_sort | Awtachew Berhe Woldu |
| collection | DOAJ |
| description | Objective This study aimed to identify determinants of immunological recovery following highly active antiretroviral therapy (HAART) among severely immunosuppressed patients at enrolment to care in Northern Ethiopia.Methods A retrospective study.Setting The study was done in Tigray Region, Northern Ethiopia.Participants The study was done among severely immunosuppressed (<200 CD4 cells/mm3) individuals at initial enrolment to care and whose samples were sent for viral load determination from April 2015 to March 2019 in Tigray Health Research Institute.Main outcomes The main outcome variable was immunological recovery, modelled using binary logistic regression.Results Among the 9687 patients with severe immunosuppression at enrolment, 2746 (28.35%, 95% CI 27.45% to 29.26%) had immunological recovery following HAART for at least 6 months. Male gender (adjusted OR (AOR)=0.50, p<0.001), age 20–34 years old (AOR=0.33, p<0.001), age ≥50 years old (AOR=0.26, p<0.001), WHO clinical stage III (OR=0.68, p=0.036) and viral non-suppression (AOR=0.38, p<0.001) were strong predictors of immunological failure.Conclusions Immunological recovery following HAART was low among severely immunosuppressed individuals at enrolment to care. Gender, age, WHO stage III and viral non-suppression were determinants of immunological recovery. Male patients, adolescents and virally non-suppressed patients should be identified as groups at higher risk for immunological failure. Therefore, greater support and intensive counselling should be prioritised among adolescents, men and virally non-suppressed patients for better immunological recovery. |
| format | Article |
| id | doaj-art-fd7027e08f6d4d8faabe14cd94036651 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-fd7027e08f6d4d8faabe14cd940366512025-08-20T02:51:20ZengBMJ Publishing GroupBMJ Open2044-60552020-08-0110810.1136/bmjopen-2020-038741Determinants of immunological recovery following HAART among severely immunosuppressed patients at enrolment to care in Northern Ethiopia: a retrospective studyAwtachew Berhe Woldu0Abraham Aregay Desta1Tewolde Wubayehu Woldearegay2Kibriti Mehari Kidane3Yemane Weldu Bahta4Kiros Fenta Ajemu5Ataklti Gebretsadik Woldegebriel6Asfawosen Aregay Berhe7Nega Mamo Bezabih8School of Public Health, Ayder College of Health Sciences, Mekelle University, Mekelle, EthiopiaDirectorate of Public Health Research and Emergency Management, Tigray Health Research Institute, Mekelle, Tigray, EthiopiaTigray Health Research Institute, Mekelle, Tigray, EthiopiaTigray Health Research Institute, Mekelle, Tigray, EthiopiaMicrobiology, Mekelle University College of Health Sciences, Mekelle, Tigray, EthiopiaTigray Health Research Institute, Mekelle, Tigray, EthiopiaTigray Health Research Institute, Mekelle, Tigray, EthiopiaTigray Health Research Institute, Mekelle, Tigray, EthiopiaTigray Health Research Institute, Mekelle, Tigray, EthiopiaObjective This study aimed to identify determinants of immunological recovery following highly active antiretroviral therapy (HAART) among severely immunosuppressed patients at enrolment to care in Northern Ethiopia.Methods A retrospective study.Setting The study was done in Tigray Region, Northern Ethiopia.Participants The study was done among severely immunosuppressed (<200 CD4 cells/mm3) individuals at initial enrolment to care and whose samples were sent for viral load determination from April 2015 to March 2019 in Tigray Health Research Institute.Main outcomes The main outcome variable was immunological recovery, modelled using binary logistic regression.Results Among the 9687 patients with severe immunosuppression at enrolment, 2746 (28.35%, 95% CI 27.45% to 29.26%) had immunological recovery following HAART for at least 6 months. Male gender (adjusted OR (AOR)=0.50, p<0.001), age 20–34 years old (AOR=0.33, p<0.001), age ≥50 years old (AOR=0.26, p<0.001), WHO clinical stage III (OR=0.68, p=0.036) and viral non-suppression (AOR=0.38, p<0.001) were strong predictors of immunological failure.Conclusions Immunological recovery following HAART was low among severely immunosuppressed individuals at enrolment to care. Gender, age, WHO stage III and viral non-suppression were determinants of immunological recovery. Male patients, adolescents and virally non-suppressed patients should be identified as groups at higher risk for immunological failure. Therefore, greater support and intensive counselling should be prioritised among adolescents, men and virally non-suppressed patients for better immunological recovery.https://bmjopen.bmj.com/content/10/8/e038741.full |
| spellingShingle | Awtachew Berhe Woldu Abraham Aregay Desta Tewolde Wubayehu Woldearegay Kibriti Mehari Kidane Yemane Weldu Bahta Kiros Fenta Ajemu Ataklti Gebretsadik Woldegebriel Asfawosen Aregay Berhe Nega Mamo Bezabih Determinants of immunological recovery following HAART among severely immunosuppressed patients at enrolment to care in Northern Ethiopia: a retrospective study BMJ Open |
| title | Determinants of immunological recovery following HAART among severely immunosuppressed patients at enrolment to care in Northern Ethiopia: a retrospective study |
| title_full | Determinants of immunological recovery following HAART among severely immunosuppressed patients at enrolment to care in Northern Ethiopia: a retrospective study |
| title_fullStr | Determinants of immunological recovery following HAART among severely immunosuppressed patients at enrolment to care in Northern Ethiopia: a retrospective study |
| title_full_unstemmed | Determinants of immunological recovery following HAART among severely immunosuppressed patients at enrolment to care in Northern Ethiopia: a retrospective study |
| title_short | Determinants of immunological recovery following HAART among severely immunosuppressed patients at enrolment to care in Northern Ethiopia: a retrospective study |
| title_sort | determinants of immunological recovery following haart among severely immunosuppressed patients at enrolment to care in northern ethiopia a retrospective study |
| url | https://bmjopen.bmj.com/content/10/8/e038741.full |
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