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Effects of an HIV-Care-Program on immunological parameters in HIV-positive patients in Yaoundé, Cameroon: a cluster-randomized trial

Abstract

Objectives

To measure the effects of an HIV-Care-Program, focusing on nutrition and lifestyle, which can be provided at scale to HIV-infected patients, on clinical and anthropometrical parameters, and health status.

Methods

A cluster-randomized trial, including 5 health facilities randomized to intervention n = 100 (HIV-Care-Program) or control n = 101 (Usual-Care). The HIV-Care-Program consisted of counseling lessons for 6 months, on: nutrition, hygiene, coping with stigma and discrimination, embedded in practical activities. Outcome variables were CD4 count after 6 months and time to antiretroviral therapy (ARV) initiation, using analysis of covariance and Kaplan–Meier method, respectively.

Results

After 6 months, CD4 count dropped by 46.3 cells (7.7 %) (intervention) and 129 (23 %) (control) (p = 0.003). Mean time to ARV; 5.9 months 95 % CI (5.9, 6.0) (intervention); 4.9 months 95 % CI (4.7, 5.2) (control) (p < 0.004). There was a partial correlation between CD4 count and initial viral load (r = −0.190, p = 0.017).

Conclusions

The intervention provides a low-cost alternative improving health status, slowing down CD4 cell decline, delaying initiation of ARV and thus freeing local ARV capacities for patients in urgent need.

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Correspondence to Germaine N. Nkengfack.

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Nkengfack, G.N., Torimiro, J.N., Ngogang, J. et al. Effects of an HIV-Care-Program on immunological parameters in HIV-positive patients in Yaoundé, Cameroon: a cluster-randomized trial. Int J Public Health 59, 509–517 (2014). https://doi.org/10.1007/s00038-014-0547-9

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  • DOI: https://doi.org/10.1007/s00038-014-0547-9

Keywords

  • HIV
  • Nutrition
  • Counseling
  • Lifestyle
  • Cluster randomization