The Effect of cART on Platelets/Lymphocytes Ratio and Viral Load Indices in HIV+ Subjects Initiating Therapy in a Tertiary Hospital in Port Harcourt, Nigeria

Abstract

<i>Background:</i> In other to enhance immune response and remove completely the danger of disease associated with AIDS, commencement of combination Antiretroviral Therapy (cART) is advocated. Common among HIV positive subjects are diseases such as cardiovascular conditions among others which happen when there is distortion in the gut mucosa, existence of co-infections, and long-term cART effect which gives room to vicious cycle that impairs on immune activities and inflammation. Inflammatory predictors which reveal the danger of morbidity and mortality are raised in HIV disease. A novel marker for inflammation – Platelet/Lymphocyte ratio (PLR), is a prognostic tool for assessing inflammation, atherosclerosis and platelet activation. <i>Aim:</i> This study was aimed at assessing prospectively, cART effect on the PLR and coagulation indices in HIV positive subjects presenting to commence cART in Rivers State University Teaching Hospital. <i>Methods</i>: Six milliliters of venous blood was collected from each participants into EDTA bottles at entry into the study, after 3 months and 6 months on cART respectively for Full Blood Count using a 3-part Sysmex XP300 and HIV Viral Load using RT-PCR Cobas TaqMan version 1.5 <i>Results</i>: A total of 40 subjects were recruited, with a mean age of 36.20 years, 14 (35%) of them were males. Mean PCV, Platelet: Lymphocyte ratio and HIV VL at Month 0 were 31.65±7.30%, 7.82±2.90 and 215767.85 ± 360338.04cp/ml respectively. There was a statistically significant increase (p <0.001) in the haematocrit by the 6^th month on cART, the reduction in Platelet: Lymphocyte count and of HIV VL by the 6^th month was also significant (P<0.001). Interestingly, PLR positively correlated with the VL at baseline (0.3676), however, there was a negative correlation at 3 months (-0125) and 6 months (-0.028). <i>Conclusion</i>: From this work it is clear that all the cases in this regard, confirm the fact that cART remarkably drops the viral load and inflammation in HIV positive subjects; nevertheless, it also shows that a low-level inflammation continues which probably leads to chronic inflammatory state, morbidity and mortality in this group of subjects.