Robustness of viral load over CD4 cell count in measuring the quality of life of people with HIV at second line regimen in Amhara region

Abstract

Access to medication for people living with HIV in need is a global health priority. Monitoring the quality of life of people under treatment helps to optimize the resource allocated for the program. Therefore, the main objective of the current study was to assess the quality of life comparing viral load and CD4 cell count and factors affecting the variable of interest among HIV-positive people under the second-line regimens. A hospital-based retrospective secondary data were used for the current investigation. The study was conducted in governmental hospitals in Amhara region. ROC curve was used for comparing CD4 cell count and viral load in assessing the quality of life and its predictors. Among the participants in second-line regimen, about 18.3% of them had CD4 cell count < 200 cells/ml of blood and 49.4% of them had detectable/unsuppressed viral load. The result of ROC curve in the current study indicates that viral load was in favors of CD4 cell count in this regard. Among the predictors for quality of life, age of patients, level of CD4 cell count while transferring to second-line regimen, sex of patients, social discrimination, level of education of patients, functional status, adherence level, disclosure status of the disease, mental depression, existence of opportunistic infections and residence area had significant effect on the variable of interest (quality of life). Viral load was in favor of CD4 cell count in assessing the quality of people under treatment. Hence, a close follow ups of patients under treatment at second-line regimen using viral load assessment is highly recommended. Due attention should be given to patients with Unsuppressed HIV viral loads. Hence, awareness creation on how the quality of life be improved should be formulated for patients during visiting times. Knowledge of HIV transmission is also important to reduce the violence and discrimination against those HIV-positive adults to improve their health status. Experience sharing between medication adherent and non-adherent patients may encourage those non-adherent patients to get lessons from adherent patients.

Keywords: AUC-ROC curve; CD4 cell count; HIV; Quality of life; Viral load; cART adherence.