Hypoalbuminemia in HIV-infected patients: its determinants and correlation with CD4 count in Northern Uganda

Hypoalbuminemia is linked to an earlier onset of acquired immune deficiency syndrome and increased mortality in patients living with HIV infection. Serum albumin is therefore an independent factor for the prediction of disease progression and mortality in People Living With HIV.

This was a cross-sectional study conducted at Lira Regional Referral Hospital in northern Uganda that targeted HIV-positive outpatients attending the ART clinic with a sample size of 373 patients. Data were collected through structured interviews and laboratory tests in which the serum albumin concentration, viral load, and CD4 count were measured.

The prevalence of hypoalbuminemia was 19.6% (73/373). A moderate positive correlation was observed between the serum albumin concentration and the CD4 count (rs = 0.43, p < 0.001). Patients with no formal education [AOR = 2.03, 95%CI = 1.69-2.07, P = 0.03] were 2.03 times more likely to have hypoalbuminemia than those who had a tertiary/university education level. The odds of having hypoalbuminemia [AOR = 2.17, CI = 1.80-3.06, P = 0.02] were 2.17 higher among HIV-infected patients who were naïve ART than among those who were on ART. Additionally, the odds of having hypoalbuminemia [AOR = 2.91, CI = 2.13-3.66, P = 0.01] were 2.91 higher among HIV-infected patients who were in stage four than among those who were in stage 1.

Hypoalbuminemia prevalence was high in PLWHIV, and a moderate positive correlation was found between the serum albumin level and the CD4 cell count. Lower education level, not being ART, and advanced HIV disease were independently associated with hypoalbuminemia.