Arjun Ghimire, Santoshi Ghimire, Hemanta Khanal, Shiv Nandan Sah, Pradeep Kumar Sah
HIV is one of the major public health problems in Nepal, fuelled by several socio-economic factors. Antiretroviral (ARV) drugs have become the cornerstone of HIV (Human Immunodeficiency Virus) care and treatment. The aim of this study to characterize the relationship for viral load response to ART with baseline CD4 cell count and base line viral load at Kirant Yakthung Chumlung Rehabilitation Center (KYC) based at Dharan city of Eastern, Nepal from July to December 2016. A total of 213 blood samples were collected through random sampling method. The collected blood was mixed properly by inverting the tubes 6-8 times immediately after collection and transferred to the laboratory for analysis within 30 minutes. CD4 count, hemoglobin level and serum albumin level determination were performed on the same day of collection within 2-3 hours of receipt. The remaining blood specimen in the vacutainer tube was centrifuged within 6 hours of collection to get plasma and kept in two aliquots of five hundred micro litres (500 μl) and frozen at -70ËšC used for plasma viral load analysis. The enumeration of CD4 lymphocytes numbers was carried out by SP flow cytometry (Trucount) on a FACS Calibur flow cytometer. HIV RNA levels were measured in plasma prepared from blood that had been collected in k3 EDTA containing tube and stored at -70ËšC. HIV viral RNA levels in patient’s plasma were detected by quantitative real-time PCR (q-PCR) Rotor gene using Qaigen kit. Among total 213 patients,123 (57.7%) were male and 90 (42.3%) were female. 101 having viral load 35-400 copies/ml showed CD4 count 200-500 cell/mm3 and 1 showed viral load below 34 and between 10001-100000 with CD4 count less than 200 cell/mm3.There was no significant association between viral load and CD4 count with P value 0.118 (P> 0.05). 77(36.1%), 30(14.0%),72(33.1%), 22(10.3%) and 11(5.16%) were under ART from 5-6 years, below 2 years, 3-4 years, 7-9 years and 8 years and above respectively. 54 were under ART treatment from 5-6 years having CD4 count 200-500. None of them showed CD4 count less than 200 whom were under treatment from 8 years and above. There was significant association between CD4 count and duration of ART treatment with the P value 0.052. 45 were under 5-6 years of ART therapy with viral load 35-400 whereas none of them showed 100001 and above viral load in the same duration. In 7-8 years of treatment and above 8 years, 1 showed viral load above 34. There was no signification between viral load and duration of treatment. HIV viral load can be reduced by using ART treatment that leads to suppression of viral load to undetectable level, having a CD4 cell count in the normal range to maintain patients for life. Its use has led to a marked reduction in AIDS (Acquired Immune Deficiency Syndrome) related morbidity and mortality.
Arjun Ghimire, Santoshi Ghimire, Hemanta Khanal, Shiv Nandan Sah, Pradeep Kumar Sah. Viral load and CD4 cell count in HIV patients receiving antiretroviral therapy from eastern Nepal. Int. J. Chem. Biol. Sci. 2020;2(2):14-19.