Association between Some Immunological Parameters and Viral Load among Antiretroviral Naive and Experienced HIV-Infected Adults in Abuja, Nigeria

The progression of Human Immunodeficiency Virus infection is often marked by significant immune system compromise. This study evaluated some immunological parameters and viral load among antiretroviral naive and experienced HIV-infected Adults in Abuja. A cross sectional design was employed, enrolling 200 participants (100 on ART and 100 ART naïve). CD4 cell count and viral load were done and comparatively analyzed. Statistically significant differences were observed in CD4 count in the ART exposed, compared to ART naive group (p<0.05). The relationship between ART adherence and viral load detection indicated a statistically significant association with a moderate negative correlation coefficient (r = -0.37). Meaning as ART adherence increases, viral load decreases.  Adherence was shown to be critical in achieving viral suppression among HIV positive individuals, as 76% of them that were adherent had undetectable viral loads. Among the ART experienced group, 24% had a detectable viral load, while it was 48% in the ART naive group, similarly, it was undetectable in those on ART (76%) and 52% among the ART naive group (p≤0.05). Regression analysis showed that the relationship between HIV viral load and CD4 count in both groups, had a statistically significant inverse relationship (p<0.05). Such that for each unit increase in viral load there was a decrease in CD4 count. 82% of those on ART were in WHO clinical stage 1 and stage 2, while 63% (ART naïve) were in these stages. And 6% (stage 4) among the ART naive, with non among those on ART. In stage 3, it was 31% vs 18 % for ART naive and ART exposed respectively. The  study highlights that ART and its adherence has the capability of reducing viral load to even undetectable levels, improve CD4 cell counts as well as the clinical stage of the patient.