Time to Immunologic Recovery and Its Determinant Factors Among Adult HIV Patients Who Initiated Antiretroviral Treatment at Hiwot Fana Specialized University Hospital, Harar, Ethiopia

Objective: To determine the time to immunologic recovery and its determinant factors among adult HIV patients who initiated antiretroviral treatment at Hiwot Fana Specialized University Hospital from February, 2018 to January, 2020. Methods: A facility-based retrospective cohort study was conducted among 301 adult HIV patients who initiated antiretroviral treatment from February, 2018 to January, 2020. Five trained nurses collected the data using data abstraction checklists. The collected data were entered into the computer using EpiData version 3.1 and then exported to Statistical Package for Social Sciences (SPSS) version 25. The median survival time to immunologic recovery was described using Kaplan-Meier (KM) estimator. Cox proportional hazards regression model was used to identify the potential determinant factors of the time to immunologic recovery. An adjusted hazard ratio (AHR) with its 95% confidence interval (CI) and p-values <0.05 were used to determine the strength and significance of associations between variables. Results: In this study, the overall median time required to reach normal CD4 count was 11 months [95% CI = (9.50, 12.51)]. Baseline functional status, ambulatory [AHR=1.383, 95% CI (1.05, 1.83)], bedridden [AHR=1.712 (1.11, 2.64)], first-line treatment classes (TDF/3TC/DTG) [AHR= 1.63, 95% CI (1.21, 2.18)], and baseline CD4 count > 350 cells/mm3 [AHR=1.65, 95% CI (1.11, 2.45)] were significantly associated with the time to immunologic recovery. Conclusion: The median time to immunologic recovery was relatively shorter. Baseline functional status (ambulatory and bedridden), baseline CD4 count, and first-line treatment class were significant predictors of time to immunologic recovery. HIV patients with working functional status should be given the necessary attention. Utilization of dolutegravir-based regimens should be encouraged to attain a normal CD4 count earlier.