BIOMARKERS OF DISEASE REMISSION IN HUMAN IMMUNODEFICIENCY VIRUS -1 INFECTION (HIV-1) ON DRUG THERAPY IN OSUN AND EKITI STATES,NIGERIA

Abstract

Identification of inexpensive and markers of disease remission in Human Immunodeficiency virus-1 infected subjects on antiretroviral therapy is desirable in developing communities where access to sophisticated laboratory facilities are still not widely available. In the present study, a total of 36 HIV-1 infected subjects aged 27-49 were recruited. Some of these subjects were lost to follow up and only five were monitored for a period of six months. The HIV-1 infected subjects selected were those with manifestation of AIDS diagnosis including a CD4<200cells/μl or self-reported occurrence of an AIDS-defining illness. They were under Highly Active Antiretroviral Therapy, HAART (Lamivudine 150mg/day, zidovudine 400mg/day and Nevirapine 200mg/day) and fifteen uninfected subjects were also selected from the same community. Venous blood samples were collected at monthly interval for a period of six months. CD4 T-lymphocyte counts; serum beta2microglobulin, serum globulin and albumin, total white blood cells count, total lymphocytes count and percentage CD4 were evaluated in the two groups. CD4 percent, serum albumin, serum globulin concentrations and total leucocyte counts in HIV-1 infected subjects under HAART 21.8 ± 6.0%, 34.9±2.07g/L, 41.07 ± 1.9/L, and 4653 ± 677 cells/μl, respectively were significantly higher as observed in uninfected subjects, 42..6±5.0%, 37.9 ± 1.47g/L, 30.1 ± `2.47g/L and 5513±746 cells/μl respectively. Mean CD4 count monthly in infected subjects was lower when compared to that of control 364 ± 57, 385 ± 47, 437 ± 76,457 ± 87, 485 ± 48 and 512 ± 92 cells/μl versus 980 ± 49,1048 ± 126, 896 ± 115, 993 ± 204, 978 ± 174 and 972±238 cells/μl while serum ß2microglobulin was significantly lower in infected subjects as follows 5.2 ± 0.6, 4.9 ± 1.0, 4.2 ± 0.5, 3.6 ± 0.5, 3.3 ± 0.5 and 2.9 ± 0.3mg/L versus uninfected controls 1.4±0.7, 1.3± 0.4, 1.6 ± 0.6, 1.1 ± 0.6, 1.3 ± 0.5 and 1.0 ± 0.6 within the period of six months(P<0.05). The differences observed for total lymphocyte counts between infected subjects 2202 ± 661cells/μl and uninfected subjects 2384 ± 478 cells/μl were not significant (P> 0.05). Blood CD4-T-lymphocyte cells counts correlated negatively with serum ß2microglobulin and correlated positively with other parameters studied. It is concluded that, in resource poor communities, serum ß2microglobulin and serum albumin could be used as alternative to the traditional markers of HIV disease. Serum globulin, CD4 T cells count, total leucocyte counts, total lymphocyte counts and percentage CD4 would be useful surrogates to follow the remission of HIV infection consequent to antiretroviral therapy.