CD4 cell count analysis among HIV patients at a tertiary hospital in South India
Keywords:
CD4 count, HIV, Anti-retroviral therapy
Abstract
Background: HIV (Human Immunodeficiency Virus) infection is characterized by a gradual deterioration of immune function. CD4 cell counts generally decrease as HIV progresses in untreated HIV-infected subjects .The present study was undertaken to know the effect of ART (Anti retroviral therapy) and the status of CD4 counts in study patients and among the genders in HIV patients.Methods: This was a cross sectional study on secondary data maintained in the ART centre for the period of 6 months from March 2015 to October 2015. The patient reports (150 cases) in the ART centre during the period of the study (6 months) were selected. CD4 cell count was done using Flow Cytometry Absolute Cell Count System.Result: Out of 150 patients 82 were male and 68 were female patients. The mean value for base line CD4 count for general group lies between those of female and male groups, with mean female (126.88cells/cmm) was lesser than that of male group (i.e. 141cells/cmm) indicating females were at higher risk of being Immunocompromised compare to males. Also that the standard deviation of female (5.4) was lesser to male (48.43) supporting the above statement. After 6 months of antiretroviral therapy, the mean CD4 counts was in the relation 352.74 cells/cmm(Male) <378.82 cells/cmm(general) <410.26 cells/cmm (Female) with the standard deviation relation 162.68 (male) <179.49 (general) <194.46 (Female).Conclusion: The results of this study indicated that antiretroviral therapy plays an important role in maintaining the CD4cell counts and CD4 counts in female patients are much lower compared to the males and they respond well to therapy compared to the male populationReferences
1. Allen TM, O'Connor DH, Jing P, Dzuris JL, Mothé BR, Vogel TU et al . Tat-specific cytotoxic T lymphocytes select for SIV escape variants during resolution of primary viraemia. Nature 2000; 407: 386-90.
2. Metzner KJ , Jin X, Lee FV, Gettie A, Bauer DE, Di Mascio M et al . Effects of in vivo CD8 T cell depletion on virus replication in rhesus macaques immunized with a live, attenuated simian immunodeficiency virus vaccine. J Exp Med 2000; 191: 1921-31.
3. UN AIDS, World AIDS Day Report, 2011.
4. Pitcher CJ, Quittner C, Peterson DM, Connors M, Koup RA, Maino VC et al. HIV-1-specific CD4 T cells are detectable in most individuals with active HIV-1 infection, but decline with prolonged viral suppression. Natural Med 1999; 5: 518-25.
5. Ogg GS, Jin X, Bonhoeffer S, Dunbar PR, Nowak MA, Monard S, et al. Quantitation of HIV-1- specific cytotoxic T lymphocytes and plasma load of viral RNA. Science 1998; 279: 2103-6.
6. NACO District HIV/AIDS epidemiological profiles developed through data triangulation, National AIDS Control Organization, Ministry of Health & Family Welfare, Government of India, 2014, Chapter 2, p 24.
7. K. Suresh Babu, Ch. Ram Babu, N. Baratha Jyothi K. Sunita. A retrospective study on status of CD4 counts and effect of ART in patients attending VCTC of MGM Hospital, Warangal, Andhra Pradesh, India IOSR Journal of Nursing and Health Science (IOSR-JNHS) 2014;3: 25-35.
8. Tiwari BR, Ghimire P, Malla S. Study on CD4 cell responses in HIV infected subjects in Nepal. Nepal Med Coll J 2008; 10: 45-47.
9. Gulick RM, Mellors JW, Havlir D, Eron JJ, Gonzalez C, McMahon D, et al . Treatment with indinavir, zidovudine and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy. New England Journal of Medicine, 1997;337: 734-739.
10. Pakker NG, Notermans DW, De Boer RJ, Roos MTL, De Wolf F, Hill A, et al. Biphasic kinetics of peripheral blood T cells after triple combination therapy in HIV-I infection; A composite of redistribution and proliferation. Nature Medicine, 1998:4; 208-214.
11. Hunt PW , Deeks SG, Rodriguez B, Valdez H, Shade SB, Abrams DI, et al. Continued CD4 cell count increases in HIV-infected adults experiencing 4 years of viral suppression on antiretroviral therapy. AIDS 2003; 17: 1907-15.
12. Patel K, Hernán MA, Williams PL, Seeger JD, McIntosh K, Van Dyke RB et al. Pediatric AIDS Clinical Trials Group 219/219C Study Team, Long-term effects of Highly Active Antiretroviral Therapy on CD4+ cell evolution among children and adolescents infected with HIV: 5 Years and Counting. Clinical Infectious Diseases, 2008;46:1751-1760.
13. Terai C, Wasson DB, Carrera CJ, Carson DA. Dependence of cell survival on DNA repair in human mononuclear phagocytes. J Immunol 1991; 147: 4302-6.
2. Metzner KJ , Jin X, Lee FV, Gettie A, Bauer DE, Di Mascio M et al . Effects of in vivo CD8 T cell depletion on virus replication in rhesus macaques immunized with a live, attenuated simian immunodeficiency virus vaccine. J Exp Med 2000; 191: 1921-31.
3. UN AIDS, World AIDS Day Report, 2011.
4. Pitcher CJ, Quittner C, Peterson DM, Connors M, Koup RA, Maino VC et al. HIV-1-specific CD4 T cells are detectable in most individuals with active HIV-1 infection, but decline with prolonged viral suppression. Natural Med 1999; 5: 518-25.
5. Ogg GS, Jin X, Bonhoeffer S, Dunbar PR, Nowak MA, Monard S, et al. Quantitation of HIV-1- specific cytotoxic T lymphocytes and plasma load of viral RNA. Science 1998; 279: 2103-6.
6. NACO District HIV/AIDS epidemiological profiles developed through data triangulation, National AIDS Control Organization, Ministry of Health & Family Welfare, Government of India, 2014, Chapter 2, p 24.
7. K. Suresh Babu, Ch. Ram Babu, N. Baratha Jyothi K. Sunita. A retrospective study on status of CD4 counts and effect of ART in patients attending VCTC of MGM Hospital, Warangal, Andhra Pradesh, India IOSR Journal of Nursing and Health Science (IOSR-JNHS) 2014;3: 25-35.
8. Tiwari BR, Ghimire P, Malla S. Study on CD4 cell responses in HIV infected subjects in Nepal. Nepal Med Coll J 2008; 10: 45-47.
9. Gulick RM, Mellors JW, Havlir D, Eron JJ, Gonzalez C, McMahon D, et al . Treatment with indinavir, zidovudine and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy. New England Journal of Medicine, 1997;337: 734-739.
10. Pakker NG, Notermans DW, De Boer RJ, Roos MTL, De Wolf F, Hill A, et al. Biphasic kinetics of peripheral blood T cells after triple combination therapy in HIV-I infection; A composite of redistribution and proliferation. Nature Medicine, 1998:4; 208-214.
11. Hunt PW , Deeks SG, Rodriguez B, Valdez H, Shade SB, Abrams DI, et al. Continued CD4 cell count increases in HIV-infected adults experiencing 4 years of viral suppression on antiretroviral therapy. AIDS 2003; 17: 1907-15.
12. Patel K, Hernán MA, Williams PL, Seeger JD, McIntosh K, Van Dyke RB et al. Pediatric AIDS Clinical Trials Group 219/219C Study Team, Long-term effects of Highly Active Antiretroviral Therapy on CD4+ cell evolution among children and adolescents infected with HIV: 5 Years and Counting. Clinical Infectious Diseases, 2008;46:1751-1760.
13. Terai C, Wasson DB, Carrera CJ, Carson DA. Dependence of cell survival on DNA repair in human mononuclear phagocytes. J Immunol 1991; 147: 4302-6.
Published
2016-05-08
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