Factors related to changes in CD4 counts after fixed-dose combination tenofovir disoproxil fumarate, lamivudine and dolutegravir (TLD) medication at Thasala Hospital, Nakhon Si Thammarat Province

Abstract

This study is an analytical cross-sectional study conducted by reviewing the medical records of HIV patients aged over 18 years who received antiretroviral therapy including tenofovir disoproxil fumarate, lamivudine and dolutegravir (TLD) at Thasala Hospital, Nakhon Si Thammarat Province, from June 2022 to May 2024. A total of 450 patients were included in the study. The data were divided into two groups based on the trend in CD4 cell count changes: Group 1 (276 patients), with a continuous increase in CD4 count, and Group 2 (174 patients), with a decreasing trend in CD4 count. Statistical analysis revealed that factors significantly associated with an increase in CD4 count included: baseline CD4 count (p<0.05), percentage of baseline CD4 cells (p<0.05), body weight before and after treatment (p<0.05), BMI before and after treatment (p<0.05), sleeping more than 5 hours per day (p<0.05), exercising more than 3 times per week (p<0.05) , drinking more than 2 liters of water per day (p<0.05), consuming more than one serving of vegetables per day (p<0.05), and having disclosure of HIV status and good social relationships (p<0.05). Additionally, engaging in religious activities, such as meditation during the past three months, was also found to be significantly associated with an increase in CD4 cell count (p<0.05). These findings suggest that both physical and psychosocial factors play an important role in immune recovery among HIV patients receiving TLD treatment, consistent with previous studies conducted in different contexts. This information can be applied to enhance HIV treatment strategies and patient care for improved effectiveness.