Socio-demographic and Clinical Variables associated with the variation of CD4 Cell Count and Body Mass Index (BMI) for HIV Positive adults receiving HAART, a joint longitudinal data analysis

Background: The rate of prevalence of HIV among adults has been increasing in Sub-Sahara African countries over the last decade. Currently, an estimated number of 722, 248 people are living with HIV, 23, 000 people are newly infected with HIV and 11,000 people are died because of AIDS related illness. The objective of this study was to identify the most significant variables associated with the variation of CD4 cell count and body mass index (BMI) of HIV positive adults who initiated HAART at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia. This study also aimed to compared the precision of parameter estimates conducted by separate and joint models. Methods: To analyze the long-term CD4 cells count and body mass index of HIV infected adults, a cohort longitudinal study of 792 HIV-infected patients was performed. A joint model was employed to identify the variables associated with the variation of CD4 cell count and body mass index of adults receiving treatment at Felege Hiwot Teaching and specialized Hospital. A random of 792 samples was taken among patients using individual charts in the hospital. Results: Among the main effects, Socio-demographic variables (Level of education, level of disclosure of the disease to persons living together and Marital status ), individuals factors(age, weight and gender), economic factors (ownership of cell phone, level of income), clinical factors (baseline CD4 cell count) retention (food and medication adherence, follow-up time/visit) significantly affected the variables of interests. Similarly, the interaction effects of follow-up times/visits * cell phone ownership, follow-up times/visits * gender, age * gender of patients significantly affected both response variables in current investigation. Conclusion: Socio-demographic, individual and Clinical variables had significant effect on CD4 cell count and BMI in HAART medication program. Follow-up time/visit in the HAART program had also direct and significant effect on the variables of interest. Older HIV patients should be targeted by appropriate public health actions, such as opportunistic screening and easier access to healthcare service. The patients should be advised to disclose the disease to get support from communities around them.