Socio-demographic and treatment-related variables associated with CD4 cell counts in Kenyan HIV patients on second-line regimens

Background: CD4 cell response in patients on second-line therapy has not been evaluated in Kenya. Patients failing second-line are changed to third-line, however, the drugs used for third-line are expensive and unavailable. Therefore, early identification of potential poor responders to treatment would lead to early intervention and thus improve therapy of patients on second-line. Objectives: To identify socio-demographic and treatment related variables that affect CD4 response of HIV-positive patients on second-line regimens in Kenyatta National Hospital (KNH). Methods: A historical cohort study carried out at KNH between January and April 2016 and entailed collection of patient data from the files. The main outcome variable was CD4 cell count. The predictor variables of interest were sex, age, education level, and ART regimens. Results: All the study participants were on a lopinavir-based regimen. The study involved 84 study participants, 59.5% female study participants and 40.5% male. Male patients had significantly lower baseline CD4 cell counts and lower CD4 cell counts at ART (antiretroviral therapy) switch to second line compared to female patients. Efavirenz-based regimens were significantly associated with low CD4 cell count at ART switch to second-line. Conclusion: Patients should be started on nevirapine-based regimens unless contraindicated. Keywords: CD4 cell count, ART switch, second-lin