Evidence for lower CD4+ T cell and higher viral load in asymptomatic HIV-1 infected individuals of India: implications for therapy initiation

Indian J Med Microbiol. 2008 Jul-Sep;26(3):217-21. doi: 10.4103/0255-0857.42031.

Abstract

Purpose: We have earlier documented that the south Indian population had lower CD4 counts. The aim of this study was to investigate a previous suggestion on a new CD4+ T cell cut off and association with HIV-1 RNA levels for decision on anti retroviral therapy in India (south).

Methods: We evaluated a new methodology i.e., artus real-time PCR and CD4+ T cell count by Guava EasyCD4 system. From 146 HIV infected individuals seen at a tertiary care centre, blood was collected for CD4+ T cell and HIV-1 RNA estimation.

Results: The receiver operating characteristic curve cut off value for the CD4 counts to distinguish between CDC clinical categories A and B was 243 cells/microL, and to distinguish B and C was 153 cells/microL. The RNA level that differentiated CDC A and B was 327473 RNA copies/mL, while for CDC B and C was 688543 copies/mL. There was a significant negative correlation (r = -0.55, P + T cell counts in HIV infected individuals.

Conclusions: A majority with CD4 counts of 201-350 cells/microL in our population had higher viral load than the treatment threshold suggested by the International AIDS society and the above two methodologies are useful in monitoring HIV infections.

Publication types

  • Evaluation Study

MeSH terms

  • CD4 Lymphocyte Count / methods
  • HIV Infections / drug therapy
  • HIV Infections / immunology*
  • HIV Infections / virology*
  • HIV-1 / isolation & purification*
  • Hospitals
  • Humans
  • India
  • Polymerase Chain Reaction / methods
  • RNA, Viral / blood
  • ROC Curve
  • Severity of Illness Index
  • Viral Load*

Substances

  • RNA, Viral