Estimating the time period between infection and diagnosis based on CD4+ counts at first diagnosis among HIV-1 antiretroviral naïve patients in Nigeria

  • Joseph C Forbi Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria
  • Thanda D Forbi Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria
  • Simon M Agwale Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria
Keywords: HIV-1, delayed diagnosis, Nigeria

Abstract

Introduction: CD4+ T-cell levels are an important criterion for categorizing HIV-related clinical conditions. Late diagnosis of infection contributes to poor medical outcomes and the continuation of viral transmission. This population-based cohort study in north central Nigeria reports the initial CD4+ lymphocyte counts at the time of first HIV diagnosis and determines the approximate time interval when HIV infection was acquired..

Methodology: Confirmed HIV-1 infected individuals (n = 588) for whom the dates of first HIV diagnosis were known were enrolled in this study. CD4+ lymphocyte counts were measured using a Fluorescence Activated Cell Sorter (FACS) platform that automatically quantifies CD4+ lymphocytes as absolute numbers of lymphocytes per μL of blood. The estimated time interval between HIV infection and time of first HIV diagnosis was determined as a function of the CD4+ lymphocytes' decay rate per calendar year.

Results: The results showed that 22.1% and 49.7% of HIV-infected individuals present late with advanced (CD4+: 200-349 cells/mL) and severe (CD4+: < 200 cells/mL) immunosuppression respectively, while only 12.1% present with CD4+ 500 cells/mL and 16.2%with CD4+ between 350-499 cells/mL. Mean CD4+ counts for females were higher when compared to those of males (p > 0.05), The time interval between HIV infection and first diagnosis was approximately 6.1 years for males and 7.3 years for females.

Conclusion: The majority of HIV-infected individuals in this study accessed health care at late stages of infection, suggesting many HIV-infected individuals in Nigeria are unaware of their HIV status. More efficient programs for early diagnosis of HIV to prevent transmission are urgently required.

Author Biographies

Joseph C Forbi, Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria
Dr Forbi Joseph is a virologist with interest is in the area of epidemiology of Retro and hepatitis viruses. He has authored or co-authored several papers that have documented the burden of HIV and hepatitis B infections in Nigeria. 


Thanda D Forbi, Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria
Dr Forbi Thanda is a clinician with interest in internal and family medicine. Her practice has challenged her to tilt towards understanding issues that influence treatment outcomes in patients with infectious diseases particularly of viral origin.
Simon M Agwale, Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria

Dr Simon Agwale is a highly respected virologist/vaccinologist especially with regard to his work on HIV vaccine development. He has a vision for the development and investigation of HIV vaccine constructs from prevalent Nigerian strains which are relevant to Nigerians. He has already made several candidates DNA vaccines, some of which have been shown to be immunogenic in animal models. His studies on molecular epidemiology of HIV in Nigeria led to the establishment of subtypes A/G recombinant and G as the most predominant subtypes in Nigeria. Dr. Agwale led the studies that established the first molecular evidence of HIV-2 in Nigeria. In addition, he reported the first case of drug resistant HIV-1 in Nigeria. Dr. Agwale spearheaded a series of studies that established a murine model of HIV Tat-mediated immune modulation. This model will be invaluable in allowing the identification of novel Tat immunogens that could afford protection against this activity of the HIV-1 Tat protein.

Published
2010-10-14
How to Cite
1.
Forbi JC, Forbi TD, Agwale SM (2010) Estimating the time period between infection and diagnosis based on CD4+ counts at first diagnosis among HIV-1 antiretroviral naïve patients in Nigeria. J Infect Dev Ctries 4:662-667. doi: 10.3855/jidc.1015
Section
Brief Original Articles