FACTORS ENHANCING CD4+T-CELL RECOVERY AMONG HIV POSITIVE PATIENTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY FOR ONE YEAR AT THE KORLE-BU TEACHING HOSPITAL, ACCRA.

ABSTRACT
The Human immunodeficiency virus (HIV), the etiologic agent of Acquired Immunodeficiency Syndrome (AIDS), since it was discovered in 1981, has become a global pandemic, because it acts by breaking down the immune system exposing the infected persons to other diseases and causing high mortalities. Currently, an estimated 34 million of the world populations are infected with the virus and results in millions of deaths around the world. CD4+T-cells (Cluster of Differentiation T-Lymphocyte cells) are part of the white blood cells which play important role in immune defense during an etiologic infection in a host. CD4+T-cells are attacked by the HIV which reduce their numbers.  Antiretroviral Therapy (ART) was introduced to reduce the adverse effects of the virus.  The ART reduces the viral load and allows the CD4+T- cells to increase.  This study sought to find out the socio-demographic factors of HIV positive patients and the hospital/system factors that enhance CD4+T- cell recovery among clients initiated on the Highly Active Antiretroviral Therapy (HAART) for at least one year.
 The study was conducted at the Fevers Unit of the Korle- Bu Teaching Hospital, Accra. HIV positive adult patients managed with HAART for one year participated in the study. Selection was done by random sampling from the computer database. A semi-structured
questionnaire was administered, after obtaining informed consent to collect data on the socio-demographics, hospital/system factors and CD4+T-cell counts status of the respondents as well.   A total of 270 respondents participated in the study. The mean age was 44±8.9 years. Males constituted 27% (n=73) and females 73% (n=197). Few of them had tertiary education (6%).  Majority, 93% (250/270) of the respondents had medium adherence. Age, sex, educational level and adherence were all found to contribute to CD4+T-cell recovery and the prevalence of co-infections was 25%. Hospital/system factors, especially the belief that most people will be treated with respect by health care workers if they have HIV/AIDS was associated with CD4+T-cell recovery at p=0.020. All the respondents (100%) were very satisfied with the clinic schedule and waiting time at the clinic while 62% (n=168/270) agreed the service received was just about what was expected.   HIV/AIDS care is very important and HAART reduces the associated morbidity and mortality. The following factors: age, sex, educational level, income level, adherence, residence, doctors/nurses relationship to patients, HAART availability, confidentiality and cost of care were found to impact on enhancing CD4+T-cell recovery.