Assessment of HIV disease progression before and after initiation of anti­retroviral therapy by CD4 &amp; CD8 T-lymphocyte count and viral load assay

Sahina Tabassum,S.M Rashed-Ul Islam,Afzalun Nessa,Munira Jahan,Saif Ullah Munshi

doi:10.3329/bsmmuj.v6i1.29084

Abstract

Backgrounds: As there is no published data regarding the response to Anti-retroviral therapy (ART) among HIV patients from Bangladesh. The present study was designed to determine the immunological and virological responses of HIV infected Bangladeshi adults starting ART. Objectives: To monitor the changes of CD4 and CD8 T-lymphocyte count and Viral load (VL) before and after three and six months of starting ART.Methods: 20 symptomatic HIV infected patients with CD4 T-lymphocyte count of &lt;350 cells/µ] of blood were initiated ART.CD4 and CDS T-lymphocyte counts were estimated by Flowcytometer and VL was dete1mined by real-time PCR technique.Results: The mean CD4 T-lymphocyte count among the sn1dy patients were 177±127 cells/µl before initiation of ART. After ART initiation, their mean CD4 count increased significantly to 368±181 and 452±183 cellshll after three and six months respectively (P&lt;0.0001).The mean CDS T-lymphocyte counts were 901±650 cells/µ! before initiation of ART, which increased to I 085±393 and 1121±372 cells/µl after three and six months respectively after ART initiation (P&gt;0.05). Before ART initiation, the mean VL was 5.25±1.19 log10 (copies/ml) among the study population which became undetectable in 15 (75%) patients after three months of ART and in another 2 (10%) patients after 6 months of ART initiation.Conclusion: Our study concluded that, ART is effective in slowing the progression of HIV infection to AIDS with good immunological and virological outcome among the ART initiators.

Highlights

HIV (PLHIV), whereas, CD4 T-lymphocyte estimation isHuman Immunodeficiency Virus (HIV) causes AIDS (Acquired Immune Deficiency Syndrome) which is a chronic, potentially life threatening condition
It damages the human immune system by damaging the body's ability to fight against opportunistic infections and tumors.l HIV infects CD4 T-lymphocytes which are the vital cells of the human immune system along with macrophages and dendritic cells.' These lead to lowering of the number of
A total of 33 serologically confirmed HIV infected patients were purposively recruited for the study from the Ashar Alo Society (AAS), Dhaka, which is a non-government organtzation (NGO) involved in management of PLHIV of Bangladesh

Summary

Introduction

Human Immunodeficiency Virus (HIV) causes AIDS (Acquired Immune Deficiency Syndrome) which is a chronic, potentially life threatening condition. It damages the human immune system by damaging the body's ability to fight against opportunistic infections and tumors.l HIV infects CD4 T-lymphocytes which are the vital cells of the human immune system along with macrophages and dendritic cells.' These lead to lowering of the number of CD4 T-lymphocytes through mechanisms causing direct the key factor for deciding when to initiate ART.'The rate of virus replication and assessing the risk of disease progression by determining HIV RNA viral load in response to ART initiation is arl important measure of efficacy testing.

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Conclusion