# A comparative assessment of CD4 recovery in a cohort of patients on different HAART regimens in a Nigerian tertiary healthcare facility

## TL;DR

This study compares CD4 cell recovery in patients on different HIV treatments in Nigeria, finding that while some improvement occurs, many patients still struggle to reach immune recovery goals.

## Contribution

The study provides a comparative analysis of CD4 recovery across four HAART regimens in a Nigerian setting, highlighting persistent challenges in immune reconstitution.

## Key findings

- CD4 cell counts increased by 65.6–82.1% of baseline values, with Efavirenz-based regimens showing the highest rise.
- Patients who reached CD4 counts ≥500 cells/ml showed an additional 22.2–34.1% increase compared to baseline.
- A high proportion (65.9–77.8%) of patients on all regimens experienced incomplete immune recovery.

## Abstract

Antiretroviral therapy is expected to produce sustained viral load reduction and a rise in CD4 cell count, both of which are important clinical markers of immune recovery. There is contrasting clinical evidence of CD4 stability among patients on long term therapy, which is a major challenge in poor resource settings. This study aims to evaluate CD4 cell recovery among patients on four regimens who have been on long term antiretroviral therapy

This was a retrospective cohort study using data from the medical records of patients on four antiretroviral regimens. A three year record of CD4 cell count of 405 randomly selected subjects was extracted for analysis.

The increase of CD4 cells was between 65.6 – 82.1% of baseline values, with the highest rise occurring with Efavirenz based regimens. Among patients who achieved target CD4 cell counts ≥ 500 cells/ml, there was further increase of between 22.2 – 34.1% compared to baseline values. The percentage of patients with incomplete immune recovery still remain high among patients on the four regimens 65.9 – 77.8%.

Immune reconstitution continue to occur among patients, however a significant proportion of patients fail to achieve and sustain target CD4 target on the long term.