Pattern and predictors of immunologic recovery in HIV infected patients
Identifieur interne : 000154 ( Pmc/Checkpoint ); précédent : 000153; suivant : 000155Pattern and predictors of immunologic recovery in HIV infected patients
Auteurs : Theophilus B. Kwofie [Ghana] ; Michael Owusu [Ghana] ; Mohamed Mutocheluh [Ghana] ; Samuel Blay Nguah [Ghana] ; Joseph Obeng-Baah [Ghana] ; Charlotte Hanson [Ghana] ; Albert Dompreh [Ghana]Source :
- BMC Research Notes [ 1756-0500 ] ; 2015.
Abstract
Although anti-retroviral therapy has generally improved the survival of HIV infected patients in many developing countries including Ghana, specific socio-demographic factors could still influence outcome of treatment. This study was designed to identify patient-specific factors that could influence the immune recovery of absolute CD4 count in HIV infected patients.
Hospital records were extracted from two health facilities in Ghana. The impact of socio-demographic factors type of ART and baseline category of CD4 counts were assessed at six monthly interval using robust linear mixed models.
A total of 214 follow up records were reviewed at Komfo Anokye Teaching Hospital (KATH) and the Kumasi South Hospital (KSH). One hundred (46.7 %) were from KATH and 114 (53.3 %) were from KSH. There was a general increase in the level of CD4 counts with time, however this increase significantly slowed down with subsequent reviews (p < 0.001). On the average the rate of CD4 count recovery slowed down by 43.6 cells/µl for every 6 months of follow up (SE = 7.69; p < 0.001). Similarly the recovery of CD4 counts in subjects with an initial high baseline CD4 counts decreased by 192.6 cells/µl (SD error = 42.3, p value ≤0.001). All other variables were not significantly associated with recovery of CD4 counts.
Our study has demonstrated the well-known phenomenon of CD4 counts increasing after administration of ARTs. CD4 counts increased more rapidly in those with relatively lower initial counts, catching up with those with high CD4 count by 2 years post treatment.
Url:
DOI: 10.1186/s13104-015-1406-3
PubMed: 26341633
PubMed Central: 4560874
Affiliations:
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Kwofie</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Owusu, Michael" sort="Owusu, Michael" uniqKey="Owusu M" first="Michael" last="Owusu">Michael Owusu</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Mutocheluh, Mohamed" sort="Mutocheluh, Mohamed" uniqKey="Mutocheluh M" first="Mohamed" last="Mutocheluh">Mohamed Mutocheluh</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Nguah, Samuel Blay" sort="Nguah, Samuel Blay" uniqKey="Nguah S" first="Samuel Blay" last="Nguah">Samuel Blay Nguah</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Obeng Baah, Joseph" sort="Obeng Baah, Joseph" uniqKey="Obeng Baah J" first="Joseph" last="Obeng-Baah">Joseph Obeng-Baah</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Hanson, Charlotte" sort="Hanson, Charlotte" uniqKey="Hanson C" first="Charlotte" last="Hanson">Charlotte Hanson</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Laboratory Department, Kumasi South Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Laboratory Department, Kumasi South Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Dompreh, Albert" sort="Dompreh, Albert" uniqKey="Dompreh A" first="Albert" last="Dompreh">Albert Dompreh</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26341633</idno><idno type="pmc">4560874</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560874</idno><idno type="RBID">PMC:4560874</idno><idno type="doi">10.1186/s13104-015-1406-3</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000137</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000137</idno><idno type="wicri:Area/Pmc/Curation">000136</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000136</idno><idno type="wicri:Area/Pmc/Checkpoint">000154</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000154</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Pattern and predictors of immunologic recovery in HIV infected patients</title><author><name sortKey="Kwofie, Theophilus B" sort="Kwofie, Theophilus B" uniqKey="Kwofie T" first="Theophilus B." last="Kwofie">Theophilus B. Kwofie</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Owusu, Michael" sort="Owusu, Michael" uniqKey="Owusu M" first="Michael" last="Owusu">Michael Owusu</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Mutocheluh, Mohamed" sort="Mutocheluh, Mohamed" uniqKey="Mutocheluh M" first="Mohamed" last="Mutocheluh">Mohamed Mutocheluh</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Nguah, Samuel Blay" sort="Nguah, Samuel Blay" uniqKey="Nguah S" first="Samuel Blay" last="Nguah">Samuel Blay Nguah</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Obeng Baah, Joseph" sort="Obeng Baah, Joseph" uniqKey="Obeng Baah J" first="Joseph" last="Obeng-Baah">Joseph Obeng-Baah</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Hanson, Charlotte" sort="Hanson, Charlotte" uniqKey="Hanson C" first="Charlotte" last="Hanson">Charlotte Hanson</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Laboratory Department, Kumasi South Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Laboratory Department, Kumasi South Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Dompreh, Albert" sort="Dompreh, Albert" uniqKey="Dompreh A" first="Albert" last="Dompreh">Albert Dompreh</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Research Notes</title><idno type="eISSN">1756-0500</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Although anti-retroviral therapy has generally improved the survival of HIV infected patients in many developing countries including Ghana, specific socio-demographic factors could still influence outcome of treatment. This study was designed to identify patient-specific factors that could influence the immune recovery of absolute CD4 count in HIV infected patients.</p></sec><sec><title>Findings</title><p>Hospital records were extracted from two health facilities in Ghana. The impact of socio-demographic factors type of ART and baseline category of CD4 counts were assessed at six monthly interval using robust linear mixed models.</p></sec><sec><title>Results</title><p>A total of 214 follow up records were reviewed at Komfo Anokye Teaching Hospital (KATH) and the Kumasi South Hospital (KSH). One hundred (46.7 %) were from KATH and 114 (53.3 %) were from KSH. There was a general increase in the level of CD4 counts with time, however this increase significantly slowed down with subsequent reviews (p < 0.001). On the average the rate of CD4 count recovery slowed down by 43.6 cells/µl for every 6 months of follow up (SE = 7.69; p < 0.001). Similarly the recovery of CD4 counts in subjects with an initial high baseline CD4 counts decreased by 192.6 cells/µl (SD error = 42.3, p value ≤0.001). All other variables were not significantly associated with recovery of CD4 counts.</p></sec><sec><title>Conclusion</title><p>Our study has demonstrated the well-known phenomenon of CD4 counts increasing after administration of ARTs. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Res Notes</journal-id><journal-id journal-id-type="iso-abbrev">BMC Res Notes</journal-id><journal-title-group><journal-title>BMC Research Notes</journal-title></journal-title-group><issn pub-type="epub">1756-0500</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26341633</article-id><article-id pub-id-type="pmc">4560874</article-id><article-id pub-id-type="publisher-id">1406</article-id><article-id pub-id-type="doi">10.1186/s13104-015-1406-3</article-id><article-categories><subj-group subj-group-type="heading"><subject>Short Report</subject></subj-group></article-categories><title-group><article-title>Pattern and predictors of immunologic recovery in HIV infected patients</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kwofie</surname><given-names>Theophilus B.</given-names></name><address><email>tbenkwofie@yahoo.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Owusu</surname><given-names>Michael</given-names></name><address><email>owusumichael-gh@hotmail.com</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Mutocheluh</surname><given-names>Mohamed</given-names></name><address><email>mutocheluh@gmail.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Nguah</surname><given-names>Samuel Blay</given-names></name><address><email>sbnguah@gmail.com</email></address><xref ref-type="aff" rid="Aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Obeng-Baah</surname><given-names>Joseph</given-names></name><address><email>jbobeng@gmail.com</email></address><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Hanson</surname><given-names>Charlotte</given-names></name><address><email>shi_hansen@hotmail.com</email></address><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Dompreh</surname><given-names>Albert</given-names></name><address><email>adompreh@gmail.com</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><aff id="Aff1"><label></label>Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</aff><aff id="Aff2"><label></label>Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana</aff><aff id="Aff3"><label></label>Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana</aff><aff id="Aff4"><label></label>Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana</aff><aff id="Aff5"><label></label>Laboratory Department, Kumasi South Hospital, Kumasi, Ghana</aff></contrib-group><pub-date pub-type="epub"><day>4</day><month>9</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>4</day><month>9</month><year>2015</year></pub-date><pub-date pub-type="collection"><year>2015</year></pub-date><volume>8</volume><elocation-id>413</elocation-id><history><date date-type="received"><day>1</day><month>11</month><year>2014</year></date><date date-type="accepted"><day>31</day><month>8</month><year>2015</year></date></history><permissions><copyright-statement>© Kwofie et al. 2015</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>Although anti-retroviral therapy has generally improved the survival of HIV infected patients in many developing countries including Ghana, specific socio-demographic factors could still influence outcome of treatment. This study was designed to identify patient-specific factors that could influence the immune recovery of absolute CD4 count in HIV infected patients.</p></sec><sec><title>Findings</title><p>Hospital records were extracted from two health facilities in Ghana. The impact of socio-demographic factors type of ART and baseline category of CD4 counts were assessed at six monthly interval using robust linear mixed models.</p></sec><sec><title>Results</title><p>A total of 214 follow up records were reviewed at Komfo Anokye Teaching Hospital (KATH) and the Kumasi South Hospital (KSH). One hundred (46.7 %) were from KATH and 114 (53.3 %) were from KSH. There was a general increase in the level of CD4 counts with time, however this increase significantly slowed down with subsequent reviews (p < 0.001). On the average the rate of CD4 count recovery slowed down by 43.6 cells/µl for every 6 months of follow up (SE = 7.69; p < 0.001). Similarly the recovery of CD4 counts in subjects with an initial high baseline CD4 counts decreased by 192.6 cells/µl (SD error = 42.3, p value ≤0.001). All other variables were not significantly associated with recovery of CD4 counts.</p></sec><sec><title>Conclusion</title><p>Our study has demonstrated the well-known phenomenon of CD4 counts increasing after administration of ARTs. CD4 counts increased more rapidly in those with relatively lower initial counts, catching up with those with high CD4 count by 2 years post treatment.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>HIV</kwd><kwd>Children</kwd><kwd>Antiretroviral therapy</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2015</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Ghana</li></country></list><tree><country name="Ghana"><noRegion><name sortKey="Kwofie, Theophilus B" sort="Kwofie, Theophilus B" uniqKey="Kwofie T" first="Theophilus B." last="Kwofie">Theophilus B. Kwofie</name></noRegion><name sortKey="Dompreh, Albert" sort="Dompreh, Albert" uniqKey="Dompreh A" first="Albert" last="Dompreh">Albert Dompreh</name><name sortKey="Hanson, Charlotte" sort="Hanson, Charlotte" uniqKey="Hanson C" first="Charlotte" last="Hanson">Charlotte Hanson</name><name sortKey="Mutocheluh, Mohamed" sort="Mutocheluh, Mohamed" uniqKey="Mutocheluh M" first="Mohamed" last="Mutocheluh">Mohamed Mutocheluh</name><name sortKey="Nguah, Samuel Blay" sort="Nguah, Samuel Blay" uniqKey="Nguah S" first="Samuel Blay" last="Nguah">Samuel Blay Nguah</name><name sortKey="Obeng Baah, Joseph" sort="Obeng Baah, Joseph" uniqKey="Obeng Baah J" first="Joseph" last="Obeng-Baah">Joseph Obeng-Baah</name><name sortKey="Owusu, Michael" sort="Owusu, Michael" uniqKey="Owusu M" first="Michael" last="Owusu">Michael Owusu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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