Assessing index CD4 and associated outcomes at 1-year in a tertiary HIV clinic, KwaZulu-Natal

South African Family Practice

Field Value
Title Assessing index CD4 and associated outcomes at 1-year in a tertiary HIV clinic, KwaZulu-Natal
Creator Moya, Zanele R. Pillay, Somasundram Magula, Nombulelo
Subject primary health care, general practice, primary human immunodeficiency virus infection; universal test and treat; cluster of differentiation 4 count, pre-test and treat era; antiretroviral treatment initiation; opportunistic infection; tuberculosis
Description Background: Human immunodeficiency virus (HIV) management guidelines have evolved from initiating therapy at CD4 counts of ≤ 200 cells/m3 to implementing universal test and treat (UTT). This study aimed to assess whether in clinical practice, patients are presenting with higher baseline CD4 counts, describe the incidence of opportunistic infections and the proportion that achieved viral suppression.Methods: A retrospective cohort design with convenience sampling was conducted. Cohort 1 included patients initiated on antiretroviral therapy (ART) between 01 January 2014 and 31 December 2014, when criteria were set at CD4 count ≤ 350 cells/mm3. Cohort 2 included patients initiated on ART between 01 January 2019 and 31 December 2019, during the UTT era.Results: At ART initiation, the median CD4 cell was 170 cells/mm3 (interquartile range [IQR]: 85.5–287) in Cohort 1 cells/mm3 and 243 cells/mm3 (IQR: 120–411) in Cohort 2. Tuberculosis was the predominant OI in the group with CD4 cell count ≤ 200 cells/m3 in both Cohort 1 (26.8%) and Cohort 2 (27.9%), p = 0.039. At 1 year, virological suppression was achieved in only 77.7% and 84.7% of Cohorts 1 and 2 patients.Conclusion: A notable portion of patients at King Edward VIII Hospital’s HIV clinic commenced ART with CD4 counts significantly below the recommended guideline thresholds.Contribution: The research revealed a delay in initiating ART. A comprehensive reevaluation is essential to pinpoint the factors contributing to this delay and to devise customised interventions.
Publisher AOSIS
Contributor n/a
Date 2024-01-25
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Retrospective Quantitative Research
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/safp.v66i1.5803
Source South African Family Practice; Vol 66, No 1 (2024): Part 1; 7 pages 2078-6204 2078-6190
Language eng
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Coverage Africa; South Africa; KwaZulu-Natal; Ethekwini District January 2014 to December 2014; January 2019 to December 2019 Female; Male; Black African; HIV positive
Rights Copyright (c) 2024 Zanele R. Moya, Somasundram Pillay, Nombulelo Magula