A comparative assessment of CD4 recovery in a cohort of patients on different HAART regimens in a Nigerian tertiary healthcare facility

Abstract

Background: Antiretroviral therapy is expected to produce sustained viral load reduction and a rise in CD4 cell count, both of which are important clinical markers of immune recovery. There is contrasting clinical evidence of CD4 stability among patients on long term therapy, which is a major challenge in poor resource settings. This study aims to evaluate CD4 cell recovery among patients on four regimens who have been on long term antiretroviral therapy Methods: This was a retrospective cohort study using data from the medical records of patients on four antiretroviral regimens. A three year record of CD4 cell count of 405 randomly selected subjects was extracted for analysis. Results: The increase of CD4 cells was between 65.6 – 82.1% of baseline values, with the highest rise occurring with Efavirenz based regimens. Among patients who achieved target CD4 cell counts ≥ 500 cells/ml, there was further increase of between 22.2 – 34.1% compared to baseline values. The percentage of patients with incomplete immune recovery still remain high among patients on the four regimens 65.9 – 77.8%. Conclusion: Immune reconstitution continue to occur among patients, however a significant proportion of patients fail to achieve and sustain target CD4 target on the long term. Keywords: CD4 recovery; different HAART regimens; Nigerian tertiary healthcare facility.