Disease progression and antiretroviral therapy in newly seropositive HIV subjects in a tertiary care hospital in North India

  • Sanjim Chadha Maulana Azad Medical College and Associated Hospitals, New Delhi, India
  • Preena Bhalla Maulana Azad Medical College and Associated Hospitals, New Delhi, India
  • Arun Kumar Jha Maulana Azad Medical College and Associated Hospitals, New Delhi, India
  • Hitender Gautam Maulana Azad Medical College and Associated Hospitals, New Delhi, India
  • Sanjeev Saini Maulana Azad Medical College and Associated Hospitals, New Delhi, India
  • S. Anuradha Maulana Azad Medical College and Associated Hospitals, New Delhi, India
  • Richa Dewan Maulana Azad Medical College and Associated Hospitals, New Delhi, India

Abstract

Introduction:In developing countries the standard methods used to monitor HIV disease progression and therapy response are clinical assessment, CD4+ T lymphocyte count measurement, and plasma viral load (PVL) quantification. These tests require expensive equipment and skilled technicians, so monitoring HIV in resource-limited countries remains challenging as few laboratories can offer these tests free of cost.

Methodology: Newly diagnosed HIV seropositive subjects (n = 130) were categorized into three study groups: CD4 counts <200 cells/µl (group A, 43 subjects); 200-500 cells/µl (group B, 44 subjects); and >500 cells/µl (group C, 43 subjects). At recruitment, PVL estimation was performed for group A subjects only, who were then initiated on highly active antiretroviral therapy (HAART) and were followed up after six months for evaluation of response to HAART by measuring the CD4 counts and PVL. Groups B and C were followed up after six months to monitor disease progression by measuring only CD4 counts.

Results: Among group A subjects, a rise in the median CD4 counts after six months of HAART was observed. At baseline, PVL ranged from 2636 to >750,000 copies/ml with a median PVL at baseline of 165,000 copies/ml. At follow-up, 90% of the study subjects had undetectable levels of viraemia. Among group B and C subjects, a fall in the CD4 counts at follow-up was observed.

Conclusions: CD4 count is a powerful tool to determine response to antiretroviral therapy (ART) and monitor disease progression in HIV/AIDS. PVL is important to assess response to ART, especially in immunovirologic discordant responses.

Author Biographies

Sanjim Chadha, Maulana Azad Medical College and Associated Hospitals, New Delhi, India
Department Of Medicine, Maulana Azad Medical College, New Delhi, India.
Preena Bhalla, Maulana Azad Medical College and Associated Hospitals, New Delhi, India

Director Professor & Head

Department Of Microbiology, Maulana Azad Medical College, New Delhi, India.

Arun Kumar Jha, Maulana Azad Medical College and Associated Hospitals, New Delhi, India

Senior Resident

Department Of Microbiology, Maulana Azad Medical College, New Delhi, India.

Hitender Gautam, Maulana Azad Medical College and Associated Hospitals, New Delhi, India

Senior Resident

Department Of Microbiology, Maulana Azad Medical College, New Delhi, India.

Sanjeev Saini, Maulana Azad Medical College and Associated Hospitals, New Delhi, India

Research Scholar

Department Of Microbiology, Maulana Azad Medical College, New Delhi, India.

S. Anuradha, Maulana Azad Medical College and Associated Hospitals, New Delhi, India

Professor

Department Of Medicine, Maulana Azad Medical College, New Delhi, India.

Richa Dewan, Maulana Azad Medical College and Associated Hospitals, New Delhi, India

Director Professor & Head

Department Of Medicine, Maulana Azad Medical College, New Delhi, India.

Published
2013-02-15
How to Cite
Chadha S, Bhalla P, Jha A, Gautam H, Saini S, Anuradha S, Dewan R (2013) Disease progression and antiretroviral therapy in newly seropositive HIV subjects in a tertiary care hospital in North India. The Journal Of Infection In Developing Countries 7 (02): 110-115. https://doi.org/10.3855/jidc.2875
Section
Original Articles

Keywords

CD4+ T lymphocyte count (CD4 count); HIV; highly active antiretroviral therapy (HAART); plasma viral load (PVL)