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

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/l. The objective is to assess CD4+ cell recovery in HIV+ patients with CD4 count below 200 cells/l) at HAART initiation. METHODS: this was a retrospective cohort study among 110 HIV+ patients with initial CD4 count = 200 cells/l. 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/l whereas at 12 months of HAART; this was 305.01 cells/l. Though some patients did not achieve a CD4 count of more than 200 cells/'l 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/l 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/l. HAART before severe immunosuppression is a key factor for immune restoration among HIV+ patients.

Keywords

• haart
• cd4+ cells
• viremia
• severe immunosuppression
• immune recovery