An Observational Study of Immunity Level of Treatment-Naive, HIV-Positive Patients Attending Tertiary Care Centre: A Cross-Sectional Study from North-Western India
DOI:
https://doi.org/10.21276/apalm.3373Keywords:
HIV, CD4 T lymphocyte count, Acquired Immunodeficiency, treatment-naive HIV-positive peopleAbstract
Background: Acquired Immunodeficiency Syndrome (AIDS) poses a significant public health challenge in India, driven by the Human Immunodeficiency Virus (HIV). HIV exhibits a selective affinity for CD4+ T lymphocytes, leading to their gradual destruction, resulting in severe immune depression and an elevated risk of opportunistic infections and cancers. The CD4+ T lymphocyte count serves as a valuable tool for initiating and monitoring the response to antiretroviral therapy. This study investigates the immunological status of newly diagnosed, treatment-naive HIV-positive individuals across diverse demographics and transmission categories, providing valuable insights for tailored intervention strategies in this population.
Materials and Methods: This was a cross-sectional study involving 200 newly diagnosed, treatment-naive HIV-positive participants. A structured proforma was used to collect demographic data, education status, occupation, transmission routes, and CD4+ T lymphocyte counts of study participants.
Results: Participants had a mean age of 41.02 years, with the majority being under 50 years old (73%). Most were male (66%), and 48% had primary-level education. Heterosexual contact was the primary transmission route (98.5%), including 18% through commercial partners. The mean CD4+ T lymphocyte count was 289.21 cells/mm³, indicating significant immunodeficiency. A majority (73%) were late presenters (CD4+ T lymphocyte counts <350 cells/mm³).
Conclusion: The study highlights the high prevalence of late HIV diagnoses, particularly among less educated and socioeconomically deprived populations. The dominance of provider-initiated testing suggests ongoing stigma surrounding voluntary testing. Urgent interventions are needed, focusing on education, occupation-related vulnerabilities, and awareness campaigns to reduce late diagnoses and enhance public health responses to HIV/AIDS.
References
Gallo RC, Montagnier L. The discovery of HIV as the cause of AIDS. N Engl J Med. 2003 Dec 11;349(24):2283-5.
ReliefWeb. Global HIV & AIDS statistics — Fact sheet 2023 - World [Internet]. 2023 [cited 2024 May 16]. Available from: https://reliefweb.int/report/world/global-hiv-aids-statistics-fact-sheet-2023?gad_source=1&gclid=Cj0KCQiAkKqsBhC3ARIsAEEjuJgfp3jB21hlS9b_18OrLQOI351cgrrCZBUUSMrCktpeA87f6MP82AkaAl-wEALw_wcB
National AIDS Control Organization (NACO). HIV Counselling and testing services (HCTS) [Internet]. India: Ministry of Health and Family Welfare, Government of India. Available from: https://naco.gov.in/hiv-counselling-and-testing-services-hcts
SAARC TB and HIV/AIDS Centre. Fact sheet on HIV/AIDS 2022 [Internet]. [cited 2024 May 16]. Available from: https://www.saarctb.org/fact-sheet-on-hiv-aids-2022/
Battistini Garcia SA, Guzman N. Acquired Immune Deficiency Syndrome CD4+ Count. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Aug 14. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513289/
Lelièvre JD, Arnoult D, Petit F, Estaquier J. Infection par le VIH1 et apoptose lymphocytaire T CD4 [HIV1-associated CD4 T lymphocyte apoptosis]. Rev Med Interne. 2003 Aug;24(8):522-9.
Antinori A, Coenen T, Costagiola D, Dedes N, Ellefson M, Gatell J, et al. Late presentation of HIV infection: a consensus definition. HIV Med. 2010 Dec 3;12(1):61-4.
Wong CS, Wong CS, Wei L, Kim YS. HIV Late Presenters in Asia: Management and Public Health Challenges. AIDS Res Treat. 2023 Jun 14;2023:9488051.
World Health Organization (WHO). HIV testing services [Internet]. Geneva: WHO. Available from: https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/testing-diagnostics/hiv-testing-services#:~:text=The%20first%20o
Graham NMH, Park LP, Piantadosi S, et al. Prognostic Value of Combined Response Markers Among Human Immunodeficiency Virus-Infected Persons: Possible Aid in the Decision to Change Zidovudine Monotherapy. Clin Infect Dis. 1995 Feb 1;20(2):352-62.
Govender S, Otwombe K, Essien T, et al. CD4 Counts and Viral Loads of Newly Diagnosed HIV-Infected Individuals: Implications for Treatment as Prevention. PLoS One. 2014 Mar 4;9(3)
.
Bishnu S, Bandyopadhyay D, Samui S, et al. Assessment of clinico-immunological profile of newly diagnosed HIV patients presenting to a teaching hospital of eastern India. Indian J Med Res. 2014 Jun;139(6):903-12.
Gorantla M, Kondagunta N. Clinico demographic profile of newly diagnosed HIV sero positive patients attending an ART centre: a cross sectional study. Int J Community Med Public Health. 2017 Jul 22;4(8):2895-900.
Kumawat S, Kochar A, Sirohi P, Garhwal J. Socio-demographic and clinical profile of HIV/AIDS patients in HAART era at a tertiary care hospital in North-West Rajasthan, India. Int J Community Med Public Health. 2017 Jan 5;3(8):2088-93.
Vyas N, Sood S, Sharma B, Kumar M. The prevalence of intestinal parasitic infestation and the related profile of the CD4 (+) counts in HIV/AIDS people with diarrhea in Jaipur city. J Clin Diagn Res. 2013 Mar;7(3):454-6.
Delpierre C, Lauwers-Cances V, Pugliese P, et al. Characteristics trends, mortality and morbidity in persons newly diagnosed HIV positive during the last decade: the profile of new HIV diagnosed people. Eur J Public Health. 2008 Feb 7;18(3):345-7.
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