Abstract

We evaluated the changes in blood profile of patients in a prospective 30 month observational follow up study involving 145 antiretroviral naive acquired immune deficiency syndrome (AIDS) participants.  Participants were divided into two groups at one year of highly active antiretroviral therapy (HAART), antiviral success (viral load < 2.60 log₁₀ copies/ml); and antiviral failure (viral load > 2.60 log₁₀ copies/ml. The mean ± standard deviation (SD) viral load in the antiviral success group (119 patients) was 5.25 ± 0.53 and 5.09 ± 0.71 log₁₀ copies/ml in antiviral failure group at baseline. Antiviral success cohort had significant reduction of viral load at 6 months, achieved viral suppression at one year and maintained undetectable viral load in the subsequent follow-up period. Antiviral failure participants on the other hand failed to achieve significant viral load suppression at six month and had fluctuation and persistence of viral load. In the antiviral success group, the mean ± SD CD4+ T-cell count increased significantly at 6 month of treatment (P ≤ 0.038 versus baseline), and in the subsequent follow-up period (P < 0.05). Detectable human immune deficiency virus-ribonucleic acid (HIV-RNA) viral load at six months was associated with unremarkable increase in CD4 count, and its persistence at 12 month with virological failure. This observation may imply that early poor immunological improvement may suggest virological failure. Initial unremarkable change in CD4 count parameters in response to HAART may predict early virological failure and efficacy of therapy in the absence of viral load in our environment.

Key words: Human immune deficiency virus (HIV), acquired immune deficiency syndrome (AIDS), highly active antiretroviral therapy (HAART), haemoglobin, white blood count, CD4⁺count.