13th Annual Conference of the British HIV Association 29 March–1 April 2007, Brighton, UK

CLINICAL AND IMMUNOLOGICAL RESPONSE TO 1 YEAR OF HAART (HIGHLY ACTIVE ANTIRETROVIRAL THERAPY) IN A PUBLIC SECTOR ANTIRETROVIRAL TREATMENT CENTRE IN GHANA

HIV Med 2007; 8(Suppl. 1):11 (abstract no. P5)

Ulrich Schwab¹, Paul Collini², Richard Amenyah³, Joseph Obeng-Baah⁴, George Bedu-Addo⁴ and David Chadwick^5
1Birmingham Heartlands Hospital, Birmingham, UK, ²University of Sheffield Medical School, Sheffield, UK, ³Family Health International, Kumasi, Ghana, ⁴Komfo Anokye Teaching Hospital, Kumasi, Ghana, ⁵James Cook University Hospital, Middlesbrough, UK

AIMS: To describe the clinical and immunological response to HAART over time in a cohort of Ghanaian HIV patients.

METHODS: A cohort of HIV-positive patients who started HAART in a public sector clinic in Ghana from 2004 is being prospectively followed. CD4 T lymphocyte counts (CD4 cells/mm³), haemoglobin (Hb g/dl), weight (wt kg) and attendance data for baseline, 6 and 12 months are presented.

RESULTS: n=249. Attendance at 12 months was 191 (78%). Median CD4 count was 118 at baseline, 277 at 6 months and 354 at 12 months. These increases were significant at each time point (P<0.0001). Stratified by CD4 count the proportions at baseline and 12 months were <200 81.5%, 15.8%; 201–350 15.7%, 33.7%; >350 2.8%, 50.5% respectively. Only 6/191 patients had a lower CD4 count at 12 months than baseline, but in 34 CD4 had dropped at 12 months after an initial 6 month rise. Baseline CD4 count in those who did and did not attend at 12 months did not differ significantly. Median Hb was 10.0 at baseline, 11.6 at 6 months and 11.9 at 12 months, with differences at each time point again being significant (P<0.0001). Those who defaulted by 12 months had a significantly lower baseline haemoglobin than those who continued to attend (mean Hb 9.39 versus 10.167, P<0.0001). Weight increased from 50 at baseline to 57 at 6 months and 59 at 12 months.

CONCLUSION: At 1 year most patients are still attending and of these 97% had higher CD4 count than at baseline. However, 18% saw a fall in CD4 count after 6 months which may or may not represent failure. Those with lower haemoglobin were less likely to continue treatment.

2007-03-29
P5

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