Antiretroviral therapy-Changing patterns of CD4 levels in HIV positive individuals: An over view

Abstract

Introduction: The major brunt of the HIV epidemic has been in South and South-east Asia—predominantly in India and Thailand. Infection with HIV leads to a progressive impairment of cellular immune function. Current CD4 count is a strong predictor of the immediate risk of acquired immunodeficiency syndrome (AIDS) CD4 cell count measurements have been central to understanding HIV disease progression, making important clinical decisions, and monitoring the response to antiretroviral therapy (ART). Aims and Objectives: 1. To know the changing patterns of CD4 levels in HIV infected persons on ART. 2. To evaluate the response to ART after 6 months & 12 months on therapy. Methods: Retrospective cross sectional study was conducted on 250 HIV positive individuals taking antiretroviral treatment at ART centre. Their personal information, opportunistic infection if any, along with CD4 levels before starting ART and 6 months & 12 months after ART were collected. Results: The mean CD4 level was more in females (343.06 cell/ cumm) than males (289.17 cell/cumm). Age group of 11- 20 yrs had more mean CD4 level (438 cell/cumm). The median CD4 level was high in females in all times i.e. before and during ART. Discussion: As per NACO guidelines, currently in India, absolute CD4 cell count is being used as the basis for initiation of ART. International and national guidelines advocate the use of CD4 count for treatment decisions, as a predictor of disease progression, a criterion for treatment initiation, and as a marker of treatment outcome in both adults and children. All the studies including present study showed that there is a clear rise in CD4 levels with ART. Keywords: HIV, ART, CD4 levels