Antiretroviral Therapy Immune Function Reinstallation in HIV-Infection in Sub Sahara Africa Population

Aims: To access antiretroviral therapy immune function reinstallation in HIV-infection in a sub-Sahara Africa population.

Study Design: The study was carried out in HIV seronegative healthy young (20-35 years) adults (CTRL), HIV Seropositive ART-Naive (20-35 years) young adults (Naïve) and HIV Seropositive on Anti-retroviral therapy (ART) aged 20-35 years old.

Place and Duration of Study: One hundred and fifty subjects were used for the study. One hundred (100) are HIV seropositive individuals, 50 on ART and 50 ART-Naive attending the Federal Medical Centre Owerri between August and December 2020. Fifty (50) healthy younger adults of the same age range served as controls in this study.

Methodology: EDTA and plain vacutainers were used to collect Venous blood from each participant. The following parameters were determined in the subjects: Viral load, CD4+, CD8+, CD4+/CD8+ ratio was calculated and CD57+ measured, Erythrocyte Sedimentation rate (ESR), and C-reactive protein (CRP) concentrations were also determined in subjects. The data generated were analysed by a one-way analysis of variances (ANOVA) using Statistical Package for Social Sciences (SPSS) version 21.

Results: The result of the study showed that Naïve individuals had a mean viral load of 41.54±13.39 copies/ml (IQR12-18) while subjects on ART had a significantly (p<0.05) lower mean viral load value of 22.26±11.31 (IQR8-54). CD4+ count obtained was 335.46 ± 76.75, 482.80 ± 88.69 and 846.08 ± 231.47cells/mm3 in NAIVE, ART and Control subjects respectively. CD8+ count obtained was 604.34 ± 126.09, 441.48 ± 94.42 and 376.86 ± 51.17 cells/mm3 in NAÏVE, ART and CTRL,respectively. Our result showed that HIV infection significantly (P<0.05) decreased CD4+/CD8+ ratio. CD57+ counts in ART treated subjects were found to be improved by treatment. CD4+ count correlated positively with viral load in NAÏVE (r = 0.799) and in ART subjects (r = 0.809). ART-NAÏVE, ART and CTRL subjects had IFN-γ concentrations of 186.44 ± 38.67, 161.83 ± 37.34 and 133.73 ± 25.97 pg/ml respectively. ESR was significantly (P<0.05) elevated in HIV seropositive subjects (NAÏVE and ART)(49.16 ± 5.49mm/hr and 24.12 ±2.88mm/hr) when compared to CTRL (7.66 ± 0.61 mm/hr). ART treatment resulted in a significant (P<0.05) decrease in ESR among seropositives. CRP concentration was significantly (P<0.05) increased in NAÏVE when compared to CTRL and subjects.

Conclusion: We conclude that Antiretroviral therapy in HIV-seropositive individuals acts to reinstall immune function and normalize fuction. Although immune function was not completely normalized, it was closer to normal than ART-naïve person whose immune function was largely compromised.