Abstract:
Objectives: To determine the clinical and immunological outcomes of a cohort of HIV-
infected patients receiving antiretroviral therapy.
Design: Retrospective study of prospectively collected data from consecutively
enrolled adult HIV-infected patients in eight HIV clinics in western Kenya.
Methods: CD4 cell counts, weight, mortality, loss to follow-up and adherence to
antiretroviral therapy were collected for the 2059 HIV-positive non-pregnant adult
patients treated with antiretroviral drugs between November 2001 and February 2005.
Results: Median duration of follow-up after initiation of antiretroviral therapy was 40
weeks (95% confidence interval, 38–43); 111 patients (5.4%) were documented as
deceased and 505 (24.5%) were lost to follow-up. Among 1766 (86%) evaluated for
adherence to their antiretroviral regimen, 78% reported perfect adherence at every visit.
Although patients with and without perfect adherence gained weight, patients with less
than perfect adherence gained 1.04 kg less weight than those reporting perfect adher-
ence (P 1⁄4 0.059). CD4 cell counts increased by a mean of 109 cells/ml during the first 6
weeks of therapy and increased more slowly thereafter, resulting in overall CD4 cell
count increases of 160, 225 and 297 cells/ml at 12, 24, and 36 months respectively. At 1
year, a mean increase of 170 cells/ml was seen among patients reporting perfect
adherence compared with 123 cells/ml among those reporting some missed doses
(P < 0.001).
Conclusions: Antiretroviral treatment of adult Kenyans in this cohort resulted in
significant and persistent clinical and immunological benefit. These findings document
