Dynamics of CD4 cell count among HIV-infected individuals in Lagos, Nigeria

Abstract

Human immunodeficiency virus (HIV) infection leads to progressive loss of CD4 T cells. Antiretroviral therapy has been able to inhibit this process, resulting in significant level of immune recovery and function. Our aim is to investigate the dynamics of CD4 recovery among HIV patients in Lagos, Nigeria. A total of 213 HIV-positive individuals were enrolled between October 2007 and May 2008, and followed up for 9 months based on CD4 count. CD4 analysis was done by flow cytometry at enrollment and after every 3 months. Data were grouped according to age range, antiretroviral treatment (ART), and time between infection and diagnosis. Kaplan-Meier survival analysis was used for data analysis. There was a significant difference in CD4 count between antiretroviral (ART) naïve and ART experienced subjects (P < 0.001). About 50% of the ART experienced population was identified to show poor CD4 reconstitution unable to achieve a CD4 of 500 cells/µl after 9 months of therapy. Time interval between infection and therapy was also identified to contribute to poor CD4 restoration. Further studies need to be done to classify immunological nonresponders among HIV patients in Nigeria. We also recommend introduction of programs that will facilitate early detection of HIV infection.

Analysis of the Influencing Factors of Immunological Nonresponders in Wuhan, China

“…Motayo et al [ 16 ] showed that the earlier the HAART starts, the faster the virus levels fall and the immune system rebuilds. Our results were consistent with these reports.…”

“…e response variables in this study were the CD4 + cell count increase. Based on the reported risk factors [14][15][16][17][18] and data collected in this study, the predictor variables that seemed to affect the CD4 + cell counts were the following: gender, body mass index (BMI), age at follow-up, duration from HIV diagnosis to HAART start, duration of HAART, transmission route, WHO clinical stage, follow-up times, co-trimoxazole preventive therapy (CPT), HAART options, HAART replacement, creatinine, hyperlipidemia, liver function impairment, and anemia.…”

“…erefore, we have attempted to analyze the factors contributing to poor immune reconstitution-by comparing patients' baseline and follow-up status based on the reported risk factors [14][15][16][17][18] and data collected in this study.…”