Estimation of the CD4 cells recovery probability following long term HAART in HIV positive patients using a non-homogenous Markov model

Alireza  Akbarzadeh Baghban; Farid  Zaeri; Seyed Saeed  Hashemi Nazari; Sara  Jambarsang; Ali  Nikfarjam; Ali  Moradi

Journal of Clinical Research in Paramedical Sciences

The Official Journal of Paramedical School, KUMS

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Estimation of the CD4 cells recovery probability following long term HAART in HIV positive patients using a non-homogenous Markov model

Author(s):

Alireza Akbarzadeh Baghban¹,

Farid Zaeri¹,

Seyed Saeed Hashemi Nazari²,

Sara Jambarsang^3,*,

Ali Nikfarjam⁴,

Ali Moradi⁵

1Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3Department of Biostatistics, PhD candidate, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4Deputy of health, Tehran University of medical sciences, Tehran, Iran

5Asadabad Health and Treatment Network, Hamadan University of Medical Sciences, Hamadan, Iran

Journal of Clinical Research in Paramedical Sciences:Vol. 5, issue 4; e81553

Published online:Jan 12, 2017

Article type:Research Article

Received:May 08, 2017

Accepted:Oct 01, 2017

How to Cite:Alireza Akbarzadeh BaghbanFarid ZaeriSeyed Saeed Hashemi NazariSara JambarsangAli NikfarjamAli Moradiet al.Estimation of the CD4 cells recovery probability following long term HAART in HIV positive patients using a non-homogenous Markov model.J Clin Res Paramed Sci.5(4):e81553.

Abstract

Introduction: Previous studies found highly active antiretroviral therapy (HAART) to be associated with improved survival among human immunodeficiency virus (HIV) infected peoples. The longer someone’s CD4 cell count remains low, the higher the risk of complications including those due to AIDS events or Opportunistic infections. Therefore, monitoring patients to maintain their high level of immune deficiency is important.

Methods: One hundred and three HIV infected patients who had already initiated HAART undergone a longitudinal investigation from the April 1995. A non-homogenous Markov model was used to estimate the probability of CD4 cells recovery in these patients.

Results: Eighteen patients died during the study treatment. Hazard ratio of recovery from state 2 of immune deficiency to state 1 is 3 times ((1.66, 5.19) 95% confidence interval) at 65 month after initiating HAART compared to before it. This parameter for recovery from state 3 to 2 was 0.3 with (0.11, 0.73) 95% confidence interval. If a patient remains at state 2 for more than 65 months after the treatment initiation the probability of recovery to state 1 was more than 55 percent.

Conclusion: The use of HAART was effective in recovering the CD4 cells count especially when a patient remains in better immune state for long years. Our findings were in line with WHO guidelines on HAART which recommend initiating HAART at CD4 cell counts of 350–499 cells/ml.

Keywords

human immunodeficiency virus (HIV)

CD4 cell counts

HAART

non-homogenous Markov model

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