Abstract:
Background: The need to study the outcome of Antiretroviral Therapy (ART) among Human Immunodeficiency
Virus (HIV) infected individuals in Ghana, a sub-Saharan African country crucial in the era of the “Treat All” policy.
The aim of this study was to analyze selected determinants of immunological and virological response to ART
among HIV infected individuals in a tertiary facility in Cape Coast, Ghana.
Methods: An analytical cross sectional study with a retrospective component was conducted in the Cape Coast
Teaching Hospital (CCTH), Central Region. Clients aged 18 years and above attending the HIV Clinics for ART and
who were on ART for 6 months or more were recruited. The viral loads, CD4 count and other socio-demographic
data were analyzed using STATA version 13 (STATA Corp, Texas USA). Descriptive analysis was done and presented
with appropriate measures of central tendencies. In addition, bivariate and multivariate analysis was carried out with
p value of 0.05 interpreted as evidence of association between variables.
Results: A total of 440 participants were included in this study with a mean age of 45.5 (±11.6) years. The mean
CD4 count at baseline, 6 months on ART and currently at study recruitment were 215.1 cells/mm3 (±152.6), 386.6
cells/mm3 (±178.5), and 579.6 cells/mm3 (±203.0) respectively. After 6 months and 12 months on ART, the number
who had achieved viral copies < 1000/ml were 149 (47.0%) and 368 (89.6%) respectively. There was strong evidence
of an association between having CD4 count < 350 cells/mm3 after 6 months on ART and having a diagnosis of
tuberculosis since HIV diagnosis (aOR 8.5, 95% CI 1.1–73.0, p = 0.05) and clients having plasma viral load > 1000
copies/ml after 6 months on ART (aOR 2.0, 95% CI 1.2–3.2, p = 0.01).
Conclusion: There was good response to ART among clients, high virological suppression and immunological recovery
hence low rates of change to second line ART regimen in this cohort studied. With strict adherence to the national policy
on HIV testing, management of positive clients and full implementation of the “Treat All” policy, Ghana could achieve, if
nothing at all, the third “90, 90, 90” target by 2020.
