Clinical and demographic characteristics of clients attending a care and treatment clinic in sub-Saharan Africa

Introduction: HIV/AIDS continues to be a major public health threat in sub-Saharan Africa, where it disproportionately affects adults in their productive years. While antiretroviral therapy (ART) has greatly improved the lives of people living with HIV (PLWH), long-term ART use and disease progression can lead to various clinical manifestations and a significant symptom burden. Understanding symptom burden and key laboratory parameters is crucial for effective patient management and improved quality of life. This study aimed to evaluate the clinical and selected laboratory features of HIV-positive patients attending a routine outpatient HIV clinic in Dar es Salaam, Tanzania.

Methods: A retrospective hospital-based cross-sectional study was conducted using electronic medical records of 7,343 HIV-positive individuals aged 18 years and above who attended the Care and Treatment Clinic (CTC) at a Regional Referral Hospital in Tanzania. Data on presenting symptoms, opportunistic infections, and laboratory investigations (HIV viral load, CD4+ T-cell count, hemoglobin levels, liver function enzymes) were retrieved. Data analysis was performed using SPSS version 23.

Results: Nausea was the most common presenting symptom, followed by cough and skin rashes. Among laboratory parameters, majority (71%) had anemia and most (85%) had normal liver enzymes. Majority (72.5%) had suppressed HIV viral load but only 20 percent had a normal CD4 count (500-1500 cells/mL). Gender-based differences were observed, with females exhibiting statistically higher CD4 counts (p < 0.0001) and men having significantly higher alanine aminotransferase (ALT) levels (p=0.0004). Differences in symptoms such as cough, weight loss, and nausea between genders were not statistically significant.

Conclusion: This study reveals crucial insights into the health of people living with HIV in Tanzania. Women were found to be disproportionately affected by HIV. Many PLWH experience nausea, and although a high percentage has achieved viral suppression, low CD4 counts and anemia remain highly prevalent. These findings suggest complex underlying factors that warrant further investigation and underscore the need for gender-sensitive care and improved strategies to manage comorbidities and support immune recovery in PLWH.