Evaluation of CD4 count and viral load as predictors of clinical progression and treatment failure in newly diagnosed Human Immunodeficiency Virus-positive patients - a cross sectional study

Background and Aims: Human Immunodeficiency Virus (HIV) is a major global public health issue. India contributes third highest burden. CD4 T cells are prime target for HIV virus, so as the HIV infection progresses, the number of these cells declines. HIV-1 RNA Viral load used as a marker to progression of the disease. The aim of this study was to determine and correlate the role of CD4 count and Viral load as predictors of clinical progression and treatment failure in newly diagnosed HIV positive patients. Materials and Methods: a cross-sectional study was conducted from July 2022 to February 2023. Sample collection (for both CD4 count and Viral load), packaging, storage, transportation and processing are done according to NACO guidelines. Results: In the present study comparison of baseline, third and sixth month CD4 count, viral load and TND (Target Not Detected) were carried out after three months of HAART treatment where clinical progression and treatment failure were predicted earlier. Even after six months of HAART treatment 21 patients showed ≤350 cells/mm3 CD4 count and 23 patients showed ≥1,000 copies/ml viral load may develop opportunistic infections due to treatment failure. Whereas, patients with viral load ≥150 copies/ml reduced to 39 (14.6%) after six months due to enhanced adherence to treatment and Opportunistic Infection (OI) management. Conclusions: Estimation of CD4 count and viral load at third month from the time of ART initiation which is different from routine sixth month testing will increase the chance of predicting clinical progression and treatment failure earlier to control OIs and non-adherence to treatment.