Factors Influencing Immunological Response in HIV Patients after Twelve Months of Antiretroviral Therapy in Dakar

Abstract

Introduction: The objective of this study was to examine the factors associated with the immunological response in patients living with HIV (PLHIV) following 12 months of antiretroviral therapy (ART). Patients and Methods: This was a descriptive-analytical study conducted from 2012 to 2018 in PLHIV followed at SMIT/CRCF of Fann hospital. To identify factors associated with CD4 delta (CD4 at M12 - CD4 at M0), univariate and multivariate linear regression were conducted. A significance threshold of 5% was established. Results: A total of 213 cases were collected, the mean age of the participants was 38 ± 11 years, and the sex ratio was 0.6. The most common comorbidities were diabetes (0.9%) and high blood pressure hypertension (6.1%). A total of 2.3% of patients were identified as having a history of injecting drug use. Patients were diagnosed with advanced HIV disease in 62.9% of cases. At the time of inclusion, the most common co-infections were hepatitis B (13.14%) and tuberculosis (13.6%). The mean difference between M0 and M12 was 197.8 (95% CI: 174.4; 221.3; p<0.001). In the univariate analysis, younger age (p < 0.02), the absence of HBV co-infection (p = 0.01), and therapeutic adherence (p < 0.01) were found to be associated with an increase in TCD4+ lymphocytes. After multivariate linear regression, age (β=-2.64; p=0.018) and adherence (β=188; p=0.001) were found to be independently associated with CD4 delta. Conclusion: Advancing age and poor adherence to ART are independent predictors of suboptimal immunological recovery among HIV-infected individuals. Tailored interventions targeting adherence support and age-related factors are needed in our settings to enhance immunological response and long-term prognosis.