HIV Insight: Social & Clinical Attributes of Patients Who Restart Antiretroviral Therapy in Central & Copperbelt Provinces, Zambia

Tuesday, April 5, 2016

Social & Clinical Attributes of Patients Who Restart Antiretroviral Therapy in Central & Copperbelt Provinces, Zambia

Background

About 30 % of the patients initiated on antiretroviral therapy in Zambia default treatment. Some of these patients later restart treatment; however, the characteristics of these patients have not been well described and documented. The aim of this study was to describe and document the socio-demographic and clinical characteristics of patients who default and restart antiretroviral therapy, and to determine the socio-demographic characteristics associated with CD4 count response at 6 and 24 months of restarting antiretroviral therapy.

Methods

A longitudinal retrospective analysis was performed on data from 535 adult patients restarting antiretroviral therapy in 2009 and 2010 at five antiretroviral therapy centres in Copperbelt and Central provinces of Zambia. To determine the association between the socio-demographic characteristics and CD4 cell count, quantile regression models were used.

Results

Older age above 45 years was associated with a significantly lower CD4 cell response by 38.1 cells/mm³ compared to the younger age (15–29 years). Patients in formal employment and self-employment gained significantly higher CD4 cells than those unemployed. In addition, baseline CD4 count, type of treatment, WHO staging, total duration on treatment and duration lost to follow-up were found to be strong predictors of CD4 cell count at 6 and 24 months after restarting antiretroviral therapy treatment.

Conclusion

Age and occupation were the only socio-demographic characteristics predicting CD4 count in the patients at 6 months after restarting antiretroviral therapy after adjusting for other confounding clinical variables.

Below: Boxplots of Interquartile range of CD4 count at restarting ART, 6 and 24 months after restaring ART