Factors Influencing Clinical Outcomes on Patients on Highly Active Antiretroviral Treatment (HAART) at Vryburg District Hospital, Northwest Province in South Africa.

Abstract

Background The use of HAART in HIV/AIDS patients has been recognised worldwide to improve the quality of life and survival prospects. Neverthess, factors such as WHO clinical stage III-IV, CD4< 200, VL> 100,000, anaemia, blood transfusion, malnutrition, male gender, intravenous drug use, drug toxicity, HAART experienced by patients, hospitalization, older age and depression have been reported to be associated with negative outcomes whereas, in contrast, white ethnicity, adherence > 90%, antiretroviral naïve subjects, longer period of viral suppression, younger age, and female gender have been reported to be associated with positive clinical outcomes. Methods The researcher conducted a descriptive retrospective study of 78 systematically selected patients who initiated HAART during the period of 5 June 2007 to 5 December 2008. Data regarding demographics, nutritional status, patients’ opportunistic infections, patients’ use of ARV drugs and HAART regimens, side effects and adverse events, baseline and follow up measurements of CD4 cell count, VL, ALT and Hb were collected at initiation, 6 and 12 months of HAART and analysed, utilizing descriptive statistics. Results Of the 78 patients recruited for the study, 60 (77%) were females and 18 (23%) males, 77 (98.8%) black and 1 (1.2%) coloured. The majority of patients belonged to the two age-groups 26-35 years (35.9%), and 36-45 (37.2%). The majority of patients [73/78 (93.4%)] were unemployed and residents of Vryburg town. Nutritionally, 17/78 (21.8%) patients were underweight. Clinically, 79.4% were classified as WHO clinical stage III - IV. The mean weight improved in both sex at 6 and 12 months of HAART respectively, from 57.5kg (SD 8.0) to 63.0kg (SD 13.0) and 65.2kg (SD 4.5) for males. 12 Conclusion The administration of HAART to patients attending ARV clinic at Vryburg District Hospital was followed by better clinical outcomes in terms of weight gain, correction of anaemia, increase in CD4 and achievement of virological suppression. Female gender, VL > 100,000 copies/ml, Younger age (< 46 years) and good adherence were found to have positive influence on clinical outcomes.