Thate RN, Ingole DN, Solanke-Surase V, Joshi K, Bajpayi S, Acharya S, Nataraj G. Role of CD4 count estimation in the era of HIV-1 viral load among PLHIV.
Indian J Med Microbiol 2023;
46:100423. [PMID:
37945117 DOI:
10.1016/j.ijmmb.2023.100423]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/29/2023] [Accepted: 06/26/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND
ART has improved the life expectancy of people living with HIV (PLHIV) by suppressing the virus and increasing CD4 count. Some PLHIV shows immune-virological discordant responses i.e. suppressed viral load to the undetectable level but still with immunological failure or good immunological response with virological failure. Immuno-virological response plays a key role to address treatment outcome, regimen change and management for people living with HIV. It is reported that PLHIV with discordant responses were found to be at an increased risk to develop AIDS and non-AIDS events related death.
AIMS & OBJECTIVE
To determine immuno-virological discordance amongst PLHIV on ART and its effect on mortality.
MATERIAL & METHOD
After getting institutional Ethics committee approval, total 1921 patients were included in the study who were on ART for at least 6 month or more and have at least two CD4 count tests results and were tested from July 2019 to June 2020. Retrospective analysis was done.
RESULTS
Total 1921 patients were included in study of which 1383 (72%) showed immuno-virological concordance & 538 (28%) showed immuno-virological discordance. Overall mortality rate among PLHIV was 3.6%. Mortality rate in immuno-virological concordant group was 2.8%. Of immuno-virological discordant population, 505 (26.3%) were virological only responders (VO) with 5.35% mortality rate & 33 (1.7%) were immunological only responders (IO) with 9.09% mortality rate. High number of immunological discordant patients in the present study warrants the further evaluation of these patients with change in appropriate treatment strategy to decrease the mortality among this group.
CONCLUSION
This study emphasizes the role of immunological monitoring as well as virological monitoring to improve the life expectancy of PLHIV.
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