Joint Modeling in Detecting Predictors of CD4 Cell Count and Status of Tuberculosis Among People Living with HIV/AIDS Under HAART at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia

Background: Globally, for individuals infected with HIV, the presence of other infections including TB tends to increase the rate of HIV replication. Of the 8.8 million TB cases worldwide, an estimated 1.1 million (13%) were found to be co-infected with HIV. This research was conducted with the objective to identify potential predictors for the status of TB and CD4 cell count under PLWHIV at Felege Hiwot Specialized Hospital, North-west Ethiopia. Methods: A retrospective repeated measurement was taken from a sample of 226 HIV patients. Separate and joint models were conducted for data analysis of CD4 cell count and TB status of people living with HIV. Results: The descriptive statistics indicated that among the HIV patients receiving HAART, 26.6% had additional TB. AIDS clinical stage, weight, and hemoglobin level had a significant positive association with CD4 cell count, but a negative association with TB status. Weight and CD4 cell count have a negative relationship with the event of HIV/TB co-infection. Hence, the expected number of CD4 cell count of HIV patients who were co-infected with TB was decreased by 2.34 as compared to people living with HIV without TB. As visiting times of patients to hospitals for treatment increased by one unit, the odds of being co-infected with TB was decreased by 0.05, and the expected number of CD4 cell count was increased by 0.2. As patients' age increased by one year, the expected number of CD4 cell count was decreased by 0.025 cells per/mm(3). Conclusion: Having lower CD4 cell count, lower weight, late WHO clinical stage, being non-adherent, having opportunistic infection, having lower hemoglobin, being ambulatory and bedridden were associated with a higher risk of co-infection of HIV/TB and were indicators of progression of the disease.