Open Access ISSN: 2155-6113
Journal of AIDS & Clinical Research
Research Article
Volume 12:6, 2021
Abstract
Background: Antiretroviral therapy (ART) has decreased the mortality and morbidity among people living with HIV and AIDS (PLWH). Viral
load (VL) has been used by clinicians as primary tool recommended by WHO to monitor patients progress on High Antiretroviral active therapy
(HAART). There is a paucity of information on Virological and immunological outcomes of HIV infected drug experience adults’ patients in north
central Nigeria. We conducted a tertiary hospital based cross-sectional study at federal medical centre in Nasarawa state between December
2019 to march 2020.
Method: A total of 474 HIV positive adult were enrolled using a Systematic random technique. Blood specimen for CD+4 T cells count and
viral load determination were obtained and PCR-Real time and Flow-cytometry were used to estimate plasma viral load and CD4+ T cell count
respectively. Frequency was used to determine percentage and logistic regression was used to determine the associated factors with Virological
suppression and immunology outcome in patients on HAART 95% CI and odd ratio (OR) was used to measure strength of association.
Results: From the 474 cohort that were enrolled 34.6% were on WHO baseline clinical stage IIV and 57.8% of cohort were on HAART, started
treatment regimen in less than a year with 42.2% diagnosed and confirmed with HIV infection between 1-5years. 57.8% were transferred into the
centre as a major reason for enrolment. 57.8% has history of TB treatment in the past while 42.2% of the study participants who were eligible for
treatment initiation were determine by CD4+ counts with a median interquartile range of 180 (92-300) cells/mm
3
. virological suppression (VL level <
1000 copies/ml) was found in 85% (95% CI 77.7, 86.1) of study participants, and it has been associated with CD4 cell count between 250 and 400
cells/mm
3
(adjusted odds ratio (AOR) = 2.56; 95% CI 1.14, 5.75) and > 499 cells/mm
3
(AOR = 7.71; 95% CI 3.48, 17.09) at VL testing and current
age > 40 years old (AOR = 5.40; 95% CI 2.3, 10.01). Similarly, favourable immunological status (≥250 cells/mm
3
for male and ≥ 600 cells/mm
3
for
female) was observed in 52.9% (95% CI 47.4, 58.8) of the study participants. Baseline CD4 cell count of > 200 cells/mm
3
, age at enrolment of 26
through 40 years old, and urban residency were significantly associated with favourable immunological outcome.
Conclusion: Low Immunological recovery among study cohort was observed although viral suppression was shown in majority of the HIV infected
adult who are on HAART. Early initiation on HAART should be encouraged in other to achieve immunological recovery and viral suppression in
order to achieve the USAIDS- 90-90-90 to end HIV pandemic by 2030.
Keywords: Suppression • Virological • Immunological • Mortality • Morbidity
Abbreviations: AIDS: Acquired Immunodeficiency Syndrome • HIV: Human Immunodeficiency Virus • HAART: High Antiretroviral Active Therapy
• ART: Antiretroviral Therapy • VL: Viral Load • WHO: World Health Organization
*Address for Correspondence: Adamu Ishaku Akyala, Department of Microbiology,
Faculty of Natural and Applied Sciences, Nasarawa State University, Keffi, Nasarawa
State, Nigeria, Tel: + 07030983655; E-mail: akyalaisaac@yahoo.com
Copyright: © 2021 Eseohe MB, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.
Received 04 June 2021; Accepted 22 June 2021; Published 29 June 2021
Virological and Immunologic Outcome of HIV Infected Drug
Experienced Adults in North Central Nigeria
Momoh Belinda Eseohe
1
, Ruth Awayimbo Jaggu
1
, Anowai Clementina O
2
, Kingsley Anyiam
1
, David Ishaleku
1
, and Adamu
Ishaku Akyala
1
*
1
Department of Microbiology, Faculty of Natural and Applied Sciences, Nasarawa State University, Keffi, Nasarawa State, Nigeria
2
Primary Health Care Board, Federal Capital Territory Administration. Abuja, Nigeria
Introduction
The human immunodeficiency virus (HIV) has continues to become a
global public health burden with 39.7 million of people living with HIV globally
in 2020 [1]. In Sub-Sahara Africa region, it’s estimated that over 70% of HIV
new infection occurs annually with increase in morbidity and mortality [2]. Over
the years, high active antiretroviral therapy (HAART) has been used to reduce
HIV related morbidity and mortality [3]. There has been great transformation in
HIV infection management from been fatal to a manageable chronic disease
due to HAART [4]. In resource limited countries, rapid scale-up of anti-retroviral
therapy (ART) for HIV (AIDS) and it has been successful [5]. In Nigeria,
significant progress has been in terms of HIV prevention and control with
programs been implemented that has reduced related HIV complications [6].
This program includes scale-up of ART treatment with optimal access. Nigeria
also helped the “test & treat” approach a 2016 WHO consolidated guideline on
the use of anti-retroviral drugs for the management for HIV infection. There has
been usable decline. In the annual new infection in Nigeria as a result of scale-
up of HIV care related services. Despite rapid scale up of HIV related service
delivery in Sub-Sahara Africa and other resource constrain countries, there
has been increase in HIV drugs resistances which has become a challenge
in many national ART roll-out programs [6], it has become pertinent to have a
robust treatment monitoring response approach [7].
Plasma HIV RNA titer and CD4+ cell count is used in clinical practice
to monitor treatment response; they are also used as diagnostic Manuel to
evaluate disease progression. In the absence of viral load testing platform in
resources constrain settings, CD4+T cell count is used to monitor the ART.
Increase in CD4+ T cell count is associated with decrease in HIV viral load for
a sustained response to HAART [7].
In clinical practice, Virological and immunological response to ART can
be measured by the ability of the immune system to suppress viral replication
which is time dependent. However, it’s critical evident for policy makers in