dc.contributor.author | Ngayo, Musa O | |
dc.contributor.author | Okalebo, Faith A | |
dc.contributor.author | Bulimo, Wallace D | |
dc.contributor.author | Mwachari, Christina | |
dc.contributor.author | Guantai, Anastasia N | |
dc.contributor.author | Oluka, Margaret | |
dc.date.accessioned | 2017-03-15T06:09:58Z | |
dc.date.available | 2017-03-15T06:09:58Z | |
dc.date.issued | 2016 | |
dc.identifier.citation | Ngayo, M. O., et al. "Impact of first line antiretroviral therapy on clinical outcomes among HIV-1 infected adults attending one of the largest hiv care and treatment program i n Nairobi Kenya." J AIDS Clin Res 7.615 (2016): 2. | en_US |
dc.identifier.uri | http://hdl.handle.net/11295/100522 | |
dc.description.abstract | Objective: This study evaluated the immunologic (CD4 cell count), virological (HIV RNA viral load), hepatic
(alanine and aspartate aminotransferase - ALT and AST), renal (creatinine) and hematological (hemoglobin -HB, White
Blood Cell - WBC, Lymphocytes - LYM and platelets - PLT) response to a six months ART treatment among HIV
participants in Nairobi Kenya.
Methods: Blood samples were obtained from 599 consenting HIV infected participants receiving HIV treatment in
Nairobi. CD4 cell counts were measured using flow cytometer and viral load determined using real-time polymerase
chain reaction. The blood hematology, liver and kidney function tests were also measured. One-way ANOVA and
Linear regression analysis were conducted.
Results: The median age at ART initiation was 41 years (IQR 35-47 years). The majority of participants (60.3%)
were female and 56.1% started on regimens with 2 NRTIs and efavirenz based NNRTI. About 40% of the participants
were failing treatment 6 month post ART initiation. The CD4 count significantly increased at the 6-month post ART
initiation (301.7 ± 199.4 to 329.4 ± 305.8; P<0.05). Hepatotoxicity (ALT and AST levels >5 times the upper limit of
normal - ULN) and renal abnormalities (elevated serum creatinine levels) were all high at month 6 compared to
baseline; ALT (2.5 to 10.5%), AST (5.3 to 23.4%) and creatinine (63.4 to 68.84%). Fewer participants at month 6 had
anemia (29.4% verses 56.4%), leucopenia (42.4% vs. 46.9%) and thrombocytopenia (6.5% vs. 84.1%) compared
to baseline. In multivariable models, baseline levels of this parameter, ART regimen and duration with HIV at ART
initiation were the most important determinant of month 6 levels.
Conclusion: These data demonstrate sustained immunologic/virologic response to ART among participants
remaining on therapy. Anemia, leucopenia and thrombocytopenia were minimized with marginal hepatotoxicity and
renal impairment seen. Interventions leading to earlier HIV diagnosis and initiation of ART could substantially improve
patient outcomes in Kenya. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.title | Impact of first line antiretroviral therapy on clinical outcomes among hiv-1 infected adults attending one of the largest HIV care and treatment program in Nairobi Kenya | en_US |
dc.type | Article | en_US |