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Relationship between CD4 count and quality of life over time among HIV patients in Uganda: A cohort study

Mwesigire, Doris Mutabazi; Martin, Faith; Seeley, Janet; Katamba, Achilles


Doris Mutabazi Mwesigire

Faith Martin

Janet Seeley

Achilles Katamba


© 2015 Mwesigire et al. Background: Immunological markers (CD4 count) are used in developing countries to decide on initiation of antiretroviral therapy and monitor HIV/AIDS disease progression. HIV is an incurable chronic illness, making quality of life paramount. The direct relationship between quality of life and CD4 count is unclear. The purpose of this study is to determine the relationship between change in CD4 count and quality of life measures in a Ugandan cohort of people living with HIV. Methods: We prospectively assessed quality of life among 1274 HIV patients attending an HIV clinic within a national referral hospital over a period of 6months. Quality of life was measured using an objective measure, the Medical Outcomes Study HIV health survey summarized as Physical Health Score and Mental Health Score and a subjective measure, the Global Person Generated Index. Generalized estimating equations were used to analyze the data. The primary predictor variable was change in CD4 count, and the outcome was quality of life scores. We controlled for sociodemographic characteristics, clinical factors and behavioral factors. Twenty in-depth interviews were conducted to assess patient perception of quality of life and factors influencing quality of life. Results: Of the 1274 patients enrolled 1159 had CD4 count at baseline and six months and 586 (51%) received antiretroviral therapy. There was no association found between change in CD4 count and quality of life scores at univariate and multivariate analysis among the study participants whether on or not on antiretroviral therapy. Participants perceived quality of life as happiness and well-being, influenced by economic status, psychosocial factors, and health status. Conclusions: Clinicians and policy makers cannot rely on change in immunological markers to predict quality of life in this era of initiating antiretroviral therapy among relatively healthy patients. In addition to monitoring immunological markers, socioeconomic and psychosocial factors should be underscored in management of HIV patients.


Mwesigire, D. M., Martin, F., Seeley, J., & Katamba, A. (2015). Relationship between CD4 count and quality of life over time among HIV patients in Uganda: A cohort study. Health and Quality of Life Outcomes, 13(1),

Journal Article Type Article
Acceptance Date Aug 23, 2015
Online Publication Date Sep 15, 2015
Publication Date Sep 15, 2015
Deposit Date Sep 18, 2019
Publicly Available Date Sep 18, 2019
Journal Health and Quality of Life Outcomes
Electronic ISSN 1477-7525
Publisher BMC
Peer Reviewed Peer Reviewed
Volume 13
Issue 1
Article Number 144
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Relationship between CD4 count and quality of life over time among HIV patients in Uganda: a cohort study (630 Kb)


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Copyright Statement
© 2015 Mwesigire et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (, which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made.

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