Date Published: September 26, 2012
Publisher: Hindawi Publishing Corporation
Author(s): Akinsegun Akinbami, Adedoyin Dosunmu, Adewumi Adediran, Sarah Ajibola, Olajumoke Oshinaike, Kikelomo Wright, Olanrewaju Arogundade.
Background. CD4 count measures the degree of immunosuppression in HIV-positive patients. It is also used in deciding when to commence therapy, in staging the disease, and in determining treatment failure. Using the CD4 count, this study aimed at determining the percentage of HIV-positives who require antiretroviral therapy at enrollment in an HIV treatment and care centre. Methods. The Baseline CD4 count, age and gender of 4,042 HAART-naïve patients, who registered between December 2006 and June 2010, at Lagos State University Teaching Hospital, Ikeja, were retrospectively studied. Data were analyzed using SPSS version 16.0 (Statistical Package for Social Sciences, Inc., Chicago, Ill). Results. Patients consisted of 2507 (62%) female and 1535 (38%) males. The mean age of males was 37.73 ± 9.48 years and that of females 35.01 ± 9.34 years. Overall, the mean CD4 count was of 298.76 ± 246.93
cells/mm3. The mean CD4 count of males was 268.05 ± 230.44
cells/mm3 and that of females 317.55 ± 254.72 cells/mm3. A total of 72.3% males, 64.3% females and 67.4% overall registered patients had CD4 count <350 cells/mm3, while only 15.1% males , 20.3% females, and 18.3% overall registered patients had CD4 count >500 cells/mm3 at registration. Conclusion. Females account for more than half of registered patients in HIV clinic and have a relatively higher CD4 count than males. About three-quarter of HIV positives require antiretroviral therapy at registration.
Worldwide Nigeria has the second highest number of new HIV/AIDS infections reported each year . About 300,000 new infections occur annually with people aged 15–24 years contributing 60% of the infections and 1.5 million people living with HIV require antiretroviral using the new WHO guidelines. Only about 30% of people living with HIV who need antiretroviral have access to it .
The records of 4,042 HAART-naïve, HIV-positive patients who registered at the HIV clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja, between December 2006 and June 2010 were retrospectively reviewed.
Data were analyzed using SPSS version 16.0 (Statistical Package for Social Sciences, Inc., Chicago, Ill); a statistical computer software. The descriptive data were given as means ± standard deviation (SD). The differences were considered to be statistically significant when the P value obtained is less than 0.05.
Data from 4,042 registered patients were reviewed, consisting of 2507 (62%) females and 1535 (38%) males (Table 1). The overall minimum age was 15years and the maximum 85 years with a mean of 36.04 ± 9.49 years (Table 1). A majority 2414 of 4042 (59.7%) of all patients were between 31–50 years, 1318 of 4042 (32.6%) between 15–30 years and only 310 of 4042 (7.7%) were older than 50 years (Table 1).
In Nigeria, the first case of HIV/AIDS was reported in 1986. HIV prevalence declined from 6% in 2001 to 4.3% in 2005, 4.2% in 2008, and 4.1% in 2010. HIV response in Nigeria was health sector driven from 1986–1989,, but a multisectoral response commenced in 2000. Funding for the HIV response in Nigeria is obtained from both domestic (Federal Government of Nigeria, private sectors and state governments) and international sources like the U.S. Government, DFID, UN agencies, and global funds. It is pertinent to determinethe percentage of HIV-infected patients who require ART at registration vis-à-vis percentage benefiting from care services in order to appreciate progress made in reaching out to those in need of accessing care and treatment.
About three-quarter of HIV positives require antiretroviral therapy at registration when 2010 WHO criteria are used for initiation of therapy, female population in HIV clinic is higher than males and the former has a relatively higher CD4 counts than the latter.