Demographic and clinical correlates of HIV-1 RNA levels in antiretroviral therapy-naive adults attending a tertiary hospital in Jos, Nigeria

• Main Authors: Joseph Anejo-Okopi (Author), Isaac Okoh Abah (Author), Yakhat Barshep (Author), Augustine Odo Ebonyi (Author), Comfort Daniyam (Author), Samson Ejiji Isa (Author), Gomerep Simji (Author), Stephen Oguche (Author), Patricia Agaba (Author), Patricia Lar (Author), Oche Agbaji (Author), John A. Idoko (Author)
• Format: Book
• Published: Elsevier, 2017-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Background: Plasma HIV-RNA viral load (VL) of HIV-infected persons is an important prognostic factor in HIV management. We determined the VL among antiretroviral therapy (ART)-naive patients to identify the association between patients' demographic, clinical and laboratory characteristics with VL. Method: A cross-sectional study of 224 ART-naive HIV-1-infected patients (≥15 years of age) accessing care at the Jos University Teaching Hospital AIDS Prevention Initiative in Nigeria ART treatment centre, from October 2010 to April 2011. A log-linear model was used to determine if VL was related to demographic and clinical variables. Results: The patients had a median (interquartile range) age of 34 (28-41) years with females in the majority (59%). Females compared to males and pulmonary tuberculosis (PTB) co-infected compared to not co-infected patients had a significantly higher VL (14.9 loge versus 11.5 logeP=0.003 and 11.31 loge versus 11.89 logeP=0.047, respectively). VL tended to decrease with increasing CD4+ cell count levels in females, but remained relatively unchanged in males across all values of CD4+ cell counts. The difference (β) in the mean change in VL between males and females was loge 0.64 copies/mL, P=0.005. Conclusion: In ART-naive HIV-1-infected patients in our setting, females had significantly higher VL and lower CD4+ cell count, at the same VL threshold, compared to males, and hence were more likely to be at a higher risk of rapid progression to AIDS. Therefore, gender-based strategies for early identification and engaging females into care are required in this setting to mitigate against rapid progression to AIDS.

Item Description

2055-6640
10.1016/S2055-6640(20)30296-X