Estimating the time period between infection and diagnosis based on CD4+ counts at first diagnosis among HIV-1 antiretroviral naïve patients in Nigeria

Autores: Forbi Joseph C., Forbi Thanda D, Agwale Simon M.

Resumen

Introduction: CD4+ T-cell levels are an important criterion for categorizing HIV-related clinical conditions. Late diagnosis of infection contributes to poor medical outcomes and the continuation of viral transmission. This population-based cohort study in north central Nigeria reports the initial CD4+ lymphocyte counts at the time of first HIV diagnosis and determines the approximate time interval when HIV infection was acquired. Methodology: Confirmed HIV-1 infected individuals (n = 588) for whom the dates of first HIV diagnosis were known were enrolled in this study. CD4+ lymphocyte counts were measured using a Fluorescence Activated Cell Sorter (FACS) platform that automatically quantifies CD4+ lymphocytes as absolute numbers of lymphocytes per μL of blood. The estimated time interval between HIV infection and time of first HIV diagnosis was determined as a function of the CD4+ lymphocytes’ decay rate per calendar year. Results: The results showed that 22.1% and 49.7% of HIV-infected individuals present late with advanced (CD4+: 200-349 cells/μL) and severe (CD4+: < 200 cells/μL) immunosuppression respectively, while only 12.1% present with CD4+> 500 cells/μL and 16.2%with CD4+ between 350-499 cells/μL. Mean CD4+ counts for females were higher when compared to those of males (p > 0.05), The time interval between HIV infection and first diagnosis was approximately 6.1 years for males and 7.3 years for females. Conclusion: The majority of HIV-infected individuals in this study accessed health care at late stages of infection, suggesting many HIV-infected individuals in Nigeria are unaware of their HIV status. More efficient programs for early diagnosis of HIV to prevent transmission are urgently required.

Palabras clave: HIV-1 delayed diagnosis Nigeria.

2011-04-19   |   455 visitas   |   Evalua este artículo 0 valoraciones

Vol. 4 Núm.10. Octubre 2010 Pags. 662-667. J Infect Developing Countries 2010; 4(10)