Longitudinal Study on Change in CD4 Cell Counts On HIV Positive Patients in Nigeria

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Author(s) Yahaya Haruna Umar | Samuel Olanrewaju O.
Pages 830-843
Volume 6
Issue 5
Date May, 2017
Keywords HIV, Cluster of Differentiation (CD4), GLMM, AIC, Comparison
Abstract

The purpose of this study is to examine and compare the utility of the GLMM models for modeling longitudinal data, with particular focus on the change in CD4 cell count in HIV patients started on Antiretroviral therapy(ART) in University of Abuja Teaching Hospital (UATH) Abuja-Nigeria. The determinants of CD4 cell counts as well as the effect of the factors studied on patients CD4+ cell count were shown in the study. The GLMM full model and the GLMM reduced model with the response variable CD4 counts at 36 month with the following predictor variables; time on ART, regimen, BMI, age and baseline CD4 count up to 33 month were fitted and analysis done with correlated data and specified variance components that represent within-subject variance in outcomes and between-subject variation. A comparison between the two models for Goodness of fit using Akaike’s Information Criterion (AIC) showed that the full model has the best fit for CD4 count and it hold promise when used with empirical variance estimates. The optimal approach will depend on study design and management goals. The importance of early treatment was evident from this study. The Initial CD4+ cell count was shown to significantly determine a patient‘s current CD4+ cell count following initiation on ART. A higher initial CD4+ cell count would result in a better rate of recovery of patients on ART. This agrees with findings of Viviane et al (2009) and Kulkarni et al (2011). This study did not show any age differentials. However, the BMI was shown to significantly determine a patient‘s current CD4 cell count hence a higher baseline BMI predicts greater gains in CD4 cell counts. This finding is in contrast to the results in the Crum- Cianflone et al study, which showed that obese patients have smaller CD4 cell count gains

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