Baseline CD4 T Cell Level Predicts Recovery Rate after Initiation of ART in HIV Infected Nigerians

Adewumi, Moses Olubusuyi; Odaibo, Georgina N.; Olaleye, O.D.

doi:10.1080/15321819.2015.1057738

Cited by 2 publications

(6 citation statements)

References 22 publications

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“…This study helps to identify the stage of the disease at which the majority of HIV individuals present voluntarily for care and treatment. Previous studies have highlighted the significance of baseline CD4 levels in predicting immune recovery and clinical outcome [ 8 ]. Studies investigating normal lymphocyte ranges including CD4+ cells have also been used to guide HIV treatment protocols in countries such as Turkey and Nigeria [ 12 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…The results presented show a picture of the immune status of a representative urban Nigerian population at the time of first voluntarily HIV testing. We therefore recommend an upward revision of the ART enrolment criteria from the 250 cells/µl to at least 350 cells/µl, which is currently being advocated [ 7 , 8 ]. Also, community engagement should be intensified in order to encourage regular and universal counseling and testing across gender and age groups in order to enable early HIV detection and to facilitate better immune recovery among HIV-positive Nigerians.…”

Section: Discussionmentioning

confidence: 99%

“…In Nigeria, current treatment guidelines are based on estimated CD4+ cell counts, and clients are enrolled for antiretroviral (ARV) therapy (ART) if and when their mean CD4 count is ≤250 cells/µl [ 7 , 8 ]. Previous studies have shown that the therapeutic outcome and CD4 T cell recovery can be influenced by the time at which care and treatment is initiated [ 8 , 9 , 10 ]. There is an ongoing debate on the need to review the current enrolment criteria into the ARV program in Nigeria, as has been done in other parts of the world [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have shown that the therapeutic outcome and CD4 T cell recovery can be influenced by the time at which care and treatment is initiated [ 8 , 9 , 10 ]. There is an ongoing debate on the need to review the current enrolment criteria into the ARV program in Nigeria, as has been done in other parts of the world [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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CD4 Decay Rate as an Indicator of the Time Interval between Initial Infection and First Diagnosis among Drug-Naïve Human Immunodeficiency Virus Seropositive Individuals in Lagos, Nigeria

Motayo

Aturaka²,

Olusola³

et al. 2016

Med Princ Pract

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Objective: The aim of this study was to determine the time interval between human immunodeficiency virus (HIV) infection and the first diagnosis among drug-naïve individuals in Badagry, Nigeria. Subjects and Methods: A sample of 213 subjects who tested HIV positive for the first time were enrolled in this study. The HIV diagnosis was performed using Startpak® and Determine® kits, and a CD4 count was carried out using a FACS Count® flow cytometer. The mean CD4 values were determined by gender and age groups. The time interval between initial HIV infection and first testing was calculated based on the average CD4 decay rate per calendar year, and data analysis was performed using SPSS software. Results: At diagnosis, the mean CD4 values showed that females recorded 270 cells/µl and males 244 cells/µl. By age range, individuals <25 years recorded 437 cells/µl, those between 25 and 40 years of age had 237 cells/µl, and those aged ≥41 years had 192 cells/µl. There was a significant difference between CD4 cell categorization and age range (p < 0.001). Subjects aged between 25 and 40 years recorded the highest distribution of all CD4 cell counts. The time interval between infection and testing for females was 8.1 years and for males 6.7 years. Within the age group <25 years the interval was 5.1 years, whilst it was 8.1 years for those aged ≥41 years. Conclusion: Most of the population presented for testing during the advanced stages of infection. We suggest an upscaling of HIV voluntary counseling and testing to encourage early detection and better treatment outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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CD4 Decay Rate as an Indicator of the Time Interval between Initial Infection and First Diagnosis among Drug-Naïve Human Immunodeficiency Virus Seropositive Individuals in Lagos, Nigeria

Motayo

Aturaka²,

Olusola³

et al. 2016

Med Princ Pract

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“…The past studies have also demonstrated that treatment outcome and CD4 cell recovery rate can be driven by the time at which care, support, and treatment is started 17,18 . Therefore, understanding the baseline CD4 count of the diagnosed treatment naïve PLHIV is very important.…”

Section: Introductionmentioning

confidence: 99%

Baseline CD4 count and the time interval between the initial HIV infection and diagnosis among PLHIV in Bhutan

Khandu

Dhakal²,

Lhazeen³

2021

Immunity Inflam & Disease

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Introduction CD4 count is an important predictor of disease progression, opportunities infection, deaths, and to understand the time interval between initial HIV infection to the first diagnosis. However, baseline CD4 count and the time period between initial infection and the diagnosis amongst PLHIV in Bhutan never been evaluated. Methods This is a retrospective study of the diagnosed PLHIV from the existing data system from January 10 to 30, 2021. Out of 512 reported HIV cases, 488 of those who were more than or equal to 18 years old and had their CD4 count testing within 6 months before initiating ART were considered for analysis. Descriptive statistical analysis was used to analyze the characteristics of the study population and relationship were established using the χ 2 Test. We have sought ethics approval and waiver for informed consent as it is the retrospective study of the client's record. The client's confidentiality was ensured by removing all the identifiers. Results The mean CD4 was 345 cells/ml for males and females. Twenty‐five percent of the clients had CD4 counts below 200, 30%, between 200 and 349, 25% between 350 and 499, and 20% above 500 cells/ml. A larger number of males showed a CD4 count below 200 cells/ml while more females showed a CD4 count more than 500 cells/ml. The mean time interval between initial infection to the first diagnosis was 4 years in males and females. However, about one‐fourth were found to have been infected between 5 and 8 years before diagnosis and less than 10% were diagnosed within less than 1 year of infection. Conclusions The study revealed a late diagnosis of HIV infection in Bhutan thereby risking the transmission to the community and risk of severe disease and mortality. The upscaling of voluntary counseling and testing, medical screening, and alternative methods like community‐based testing including HIV Self Testing for early detection needs to be implemented in the country.

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Baseline CD4 T Cell Level Predicts Recovery Rate after Initiation of ART in HIV Infected Nigerians

Cited by 2 publications

References 22 publications

CD4 Decay Rate as an Indicator of the Time Interval between Initial Infection and First Diagnosis among Drug-Naïve Human Immunodeficiency Virus Seropositive Individuals in Lagos, Nigeria

CD4 Decay Rate as an Indicator of the Time Interval between Initial Infection and First Diagnosis among Drug-Naïve Human Immunodeficiency Virus Seropositive Individuals in Lagos, Nigeria

Baseline CD4 count and the time interval between the initial HIV infection and diagnosis among PLHIV in Bhutan

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