COMPARISON OF CLINICAL AND LABORATORY PROFILE OF HAART ADHERENT AND NON-ADHERENT HIV/AIDS PATIENTS IN CALABAR, NIGERIA

Agam Ebaji Ayuk, Ndifreke Udonwa, Abraham Gyuse

Abstract


Background: The burden of HIV/AIDS has reduced following sustained interventions especially with introduction of highly active antiretroviral therapy (HAART). HIV/AIDS has become a chronic condition for which adherence to therapy is of public health relevance. This study was aimed at assessing the relationship between adherence to HAART and clinical and laboratory outcomes in a tertiary centre.

 

Methodology: This was a cross-sectional descriptive study of three hundred and forty eight (348) respondents on HAART. Adherence was measured using an adapted adult AIDS clinical trial group (AACTG) with optimal adherence set at ≥95%. Clinical stage, anthropometry, CD4, total lymphocyte and haemoglobin were used to monitor clinical, immunological and haematological outcome of adherence.

 

Result: The mean (SD) age of respondents was 34.8 (5.3) years, ranging from 18 - 68 years, with male: female ratio of 1:1.7. Adherence to HAART was 89.1%. Non-adherent compared with adherent respondents, had marginally significantly higher proportion of WHO AIDS Stage 3 disease (44.7% vs. 26.4%, p=0.05). Comparing baseline with current values, change in mean CD4 cell counts was significantly higher among adherent compared with non-adherent respondents (187 vs. 125, p=0.00). Also, change in mean total lymphocyte counts was significantly higher among adherent compared with non-adherent respondents (508 vs. 314, p=0.00). Change in CD4 cell count significantly correlated with adherence (t=0.15, p<0.05).

 

Conclusion: Self-reported optimal adherence significantly correlated with immunological recovery, which is a key determinant of good clinical outcome in HIV patients. Measures aimed at sustaining adherence to HAART, and regular assessment of CD4 count should be strengthened.

Keywords


Adherence, CD4 count, Total lymphocyte count, Adult AIDS Clinical Trial Group

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