Common Risk Factors for CD4 Cell Count and Hemoglobin Level among Female Adult HIV-Positive Patients: A Retrospective Longitudinal Study.

Background: HIV is one of the most significant worldwide health concerns of the twenty-first century and a serious threat to human society. Hemoglobin level and CD4 cell count are two of the most important biomarkers of HIV progression and patient survival. The objective of this study was to identify common risk factors associated with CD4 cell count and hemoglobin level among adult female HIV-positive patients treated with ART at the University of Gondar Comprehensive Specialized Hospital, Ethiopia. Methods: The source of data in this study was secondary data conducted in the University of Gondar Comprehensive Specialized Hospital from September 2015 to March 2022 . Data exploration in this study was normal histogram plot, box plot, and Q-Q plot considered to gain some visions of the data related to CD4 cell count and hemoglobin level. A Bayesian joint model was used in this longitudinal data set to get a wide range of information about adult female HIV-patients. Results: The mean with a standard deviation of hematocrit (%), red blood cell (106/µl), lymphocyte (%), and weight (kg) of female patients were 37.2 (3.8), 4.0 (1.6), 43.6 (11.8), and 44.9 (9.4), respectively. In this study, the random intercept model for CD4 cell count and the random intercept and slope model for hemoglobin level were considered as the best selected model. Visit time, hematocrit, weight, RBC, lymphocyte count, educational status, marital status, disclosure, and substance use were common risk factors for CD4 cell count and hemoglobin level. Conclusion: This study concluded that, the risk factors visit time, weight, secondary educators, tertiary educators, married patients, patients who disclosed their HIV status to family members were associated with high CD4 cell count and hemoglobin level. While, hematocrit, RBC, lymphocyte count, separated marital status, widowed marital status, and substance-addicted patients were associated with low CD4 cell count and hemoglobin level. The author recommended that FMOH or other health professionals, program planners, decision makers, project implementers, government, and nongovernmental organizations should be given special attention for adult female patinets to minimize the risk of HIV progression and improve their health status. The author also recommended that health staff should conduct health-related studies for patients to examine continuous checkups. Health professionals also should give more attention to types of ART medication to reduce the progression of disease when the patients come back again into the hospital. Finally, adult female HIV-positive patients should be given special attention based on these important factors to improve their CD4 cell count, hemoglobin level, and better health quality.

Determinants of hemoglobin level and time to default from Highly Active Antiretroviral Therapy (HAART) for adult clients living with HIV under treatment; a retrospective cohort study design.

HIV/AIDS is one of the most devastating infectious diseases affecting humankind all over the world and its impact goes beyond public health problems. This study was conducted to investigate the joint predictors of hemoglobin level and time to default from treatment for adult clients living with HIV/AIDS under HAART at the University of Gondar Comprehensive and Specialized Hospital, North-west Ethiopia. The study was conducted using a retrospective cohort design from the medical records of 403 randomly selected adult clients living with HIV whose follow-ups were from September 2015 to March 2022. Hemoglobin level was projected using Sahli's acid-hematin method. Hence, the hemoglobin tube was filled with N/10 hydrochloric acid up to 2 g % marking and the graduated tube was placed in Sahli's hemoglobin meter. The blood samples were collected using the finger-pick method, considering 22 G disposable needles. The health staff did this. From a total of 403 adult patients living with HIV/AIDS included in the current study, about 44.2% defaulted from therapy. The overall mean and median estimated survival time of adult clients under study were 44.3 and 42 months respectively. The patient's lymphocyte count (AHR = 0.7498, 95% CI: (0.7411: 0.7587), p-value < 0.01), The weight of adult patients living with HIV/AIDS (AHR = 0.9741, 95% CI: (0.9736: 0.9747), p-value = 0.012), sex of adult clients (AHR = 0.6019, 95% CI: (0.5979, 0.6059), p-value < 0.01), WHO stages III compared to Stage I (AHR = 1.4073, 95% CI: (1.3262, 1.5078), p-value < 0.01), poor adherence level (AHR = 0.2796, 95% CI: (0.2082, 0.3705) and p-value < 0.01), bedridden patients (AHR = 1.5346, 95% CI: (1.4199, 1.6495), p-value = 0.008), and opportunistic infections (AHR = 0.2237, 95% CI: (0.0248, 0.4740), p-value = 0.004) had significant effect on both hemoglobin level and time to default from treatment. Similarly, other co-morbidity conditions, disclosure status of the HIV disease, and tobacco and alcohol addiction had a significant effect on the variables of interest. The estimate of the association parameter in the slope value of Hgb level and time default was negative, indicating that the Hgb level increased as the hazard of defaulting from treatment decreased. A patient with abnormal BMI like underweight, overweight, or obese was negatively associated with the risk of anemia (lower hemoglobin level). As a recommendation, more attention should be given to those patients with abnormal BMI, patients with other co-morbidity conditions, patients with opportunistic infections, and low lymphocytes, and bedridden and ambulatory patients. Health-related education should be given to adult clients living with HIV/AIDS to be good adherents for medical treatment.

Joint clinical determinants for bivariate hematological parameter among TB/HIV co-infected adults under TB/HIV treatment in university of Gondar comprehensive specialized hospital: Retrospective panel data study.

BACKGROUND: Worldwide ranking above HIV/AIDS, tuberculosis is continues to have a significant effect on public health and the leading cause of death due to high progression of HIV. The objective of current study was identify joint clinical determinants that affecting bivariate hematological parameter among TB/HIV co-infected adults under TB/HIV treatment in university of Gondar comprehensive specialized hospital. METHOD: The result of these study was conducted at university of Gondar comprehensive specialized hospital, Gondar, Ethiopia by using a retrospective cohort follow up study from September 2015-march 2022 G.C. The source of data in this study was secondary data obtained from patients chart. Bayesian approach of longitudinal linear mixed effect sub model was used in panel data set to get wide range of information about TB/HIV co-infected patients. RESULT: Out of 148 co-infected participants more than half of the patients (56.1%) and (52.7%) accounted for CPT and INH non users, of which 10.8% and 10.3% had the outcome of mortality respectively. The random intercept and slope model were selected for repeated measure hemoglobin level and hematocrit based on deviance information criteria (DIC), and probability of direction (Pd) under the full model. CONCLUSION: Current study revealed that clinical predictors red blood cell count, platelet cell count, fair and good treatment adherence, other ART regiment, IPT drug users, and viral load count < 10,000 copies/mL, were associated with high hemoglobin level concentration while, lymphocyte count, WHO clinical stage-IV,1e ART regiment, and patients with OIs results for low hemoglobin level concentration. Likewise, red blood cell count, platelet cell count, fair and good treatment adherence, IPT drug users, and viral load count < 10,000 copies/mL co-infected patients had high hematocrit, while lymphocyte count, WHO clinical stage-III,1c ART regiment, and patients with OIs significantly leads to low hematocrit. Health professionals give more attention to these important predictors to reduce progression of disease when the co-infected patients come back again in the hospital. In addition, health staff should conduct health related education for individuals to examine continuous check-up of co-infected patients.

Predictors for viral load suppression among HIV positive adults under ART treatment in University of Gondar Comprehensive Specialized Hospital: retrospective cohort study.

HIV continues to be a serious global public health concern, having 40.4 million lives up to now and continuing to spread throughout all countries. The objective of this study was to identify predictors for viral load suppression among HIV positive adults under ART treatment in University of Gondar Comprehensive Specialized Hospital, Ethiopia. An institution based retrospective cohort study design was carry out from 30th March 2017-30th March 2022.Accelerated failure time model were employed to get wide-ranging information about adult HIV positive patients. In this study out of 378 study participants, about 77.8% were suppressed viral load count and the rest were censored. The Weibull AFT model results revealed that predictors were older age (φ = 0.774, 95% CI 0.602-0.793), primary educators (φ = 0.931, 95% CI 0.809-0.964), patients disclosed the disease to family member (φ = 1.093, 95% CI 1.001-1.457), viral load < 10,000 copies/mL (φ = 1.153, 95% CI 1.015-1.309), hemoglobin level ≥ 11g/dL (φ = 1.145, 95% CI 1.028-1.275), CD4 cell count ≥ 200 per mm3 (φ = 1.147, 95% CI 1.019-1.290), weight ≥ 50 kg (φ = 1.151, 95% CI 1.033-1.275), BMI between 18.5 and 24.9 kg/m3 (φ = 1.143, 95% CI 1.007-1.296), fair treatment adherence (φ = 1.867, 95% CI 1.778-1.967), good treatment adherence (φ = 1.200, 95% CI 1.046-1.377), advanced WHO clinical stages (φ = 0.923, 95% CI 0.899-0.946), patients with OCC (φ = 0.821, 95% CI 0.720-0.936) and substance use (φ = 0.876, 95% CI 0.773-0.993) statistically significant predictors for viral load suppression at 5% level of significance. Then, near intensive care of adult patients' whose ages between 25 and 34 years, primary educational level, advanced WHO clinical stage, patients with OCC, and substance users can help them improve their health and live longer. Lastly, further studies should be done on HIV positive adult patients by considering other important independent variables that were not included in this study.

Predictors for CD4 cell count and hemoglobin level with survival time to default for HIV positive adults under ART treatment at University of Gondar Comprehensive and Specialized Hospital, Ethiopia.

BACKGROUND: HIV/AIDS is the most known powerful risk factor for morbidity and mortality in the world. The greatest biological markers in HIV patients are CD4 cell count and hemoglobin level, as they are independent predictors of survival of HIV patients. The objective of this study was to investigate the common socio-demographic, clinical, and behavioral Predictor's affecting the CD4 cell count, and hemoglobin level with survival time to default from ART treatment among HIV positive adults under ART treatment at university of Gondar comprehensive and specialized hospital, North-west Ethiopia. METHOD: This study was conducted at University of Gondar comprehensive specialized hospital by using a retrospective cohort follow up study design. The source of data in this study was secondary data obtained from patients chart. Bayesian joint models were employed to get wide-ranging information about HIV/AIDS progression. RESULT: From a total of 403 HIV positive adults, about 44.2% were defaulted from therapy and the rest were actively followed ART treatment. The estimate of the association parameter for the current true value of CD4 cell count ([Formula: see text]), and hemoglobin level ([Formula: see text]), trend of CD4 cell count ([Formula: see text]) and hemoglobin level ([Formula: see text]) is positive. Positive values indicating that the higher CD4 cell count and hemoglobin level is related with the higher time of defaulting from ART. Predictor's hematocrit, weight, platelet cell count, lymphocyte count, sex, adherence, and WHO clinical stage were joint determinate risk factors affecting CD4 cell count, hemoglobin level and time to default at 5% level of significance. CONCLUSION: Current study results revealed that hematocrit, weight, BMI, platelet cell count, lymphocyte count, sex (female), and good treatment adherence were significantly associated with higher CD4 cell count, hemoglobin level and time to default while having advanced WHO clinical stage-IV had significantly decreased CD4 cell, hemoglobin level, and time to default from treatment. Patients with HIV should be given special attention based on these important factors to improve their health and prolong their lives.