Authors: Javaid M.I , Iqbal H.M.N , Ghazanfar M , Haider S , Mazhar S , Natiq M , Ahmad R , Anwar A

Abstract

Background and Objective: The human immunodeficiency virus (HIV) infects, destroys and paralyzes the immune system of human body. There is steady rise in the number of cases having AIDS (acquired immunodeficiency syndrome). Decision regarding when to initiate antiretroviral treatment or chemo-prophylaxis for opportunistic infections and clinical monitoring is done with the help of CD4+ counts. Flowcytometry is very expensive and available at specialized centers. Therefore, clinical indicators are needed to be explored to fore see low CD4+ counts and disease progress.
Methods: It was a cross-sectional study and conducted among 106 HIV infected, treatment naive individuals with all genders and age range of 18-65 years. Responses regarding clinical signs and symptoms were entered on pre designed structured proforma by history and clinical examination. Blood samples were taken and base line CD4+lymphocyte count evaluated on flowcytometer. Data was analyzed in software SPSS 23 and P value of < 0.05 was considered statistically significant.
Results: Participants in this study commonly reported weight loss, fever and cough in 79.2%, 94. 3% and 34.9% of the subjects respectively. Generalized lymphadenopathy and pallor were predominant signs in 22.6% and 54.7% of the subjects. Tuberculosis and HCV infection were seen in 12.3% and 17% subjects. CD4+ counts were lower in symptomatic patients and those having oral thrush, weight loss and other clinical conditions.
Conclusion: Oral thrush and weight loss predicted low CD4+ counts and these may be considered as indicator of disease progression in HIV infection. Systematic studies are required on the natural history of disease on larger scale to identify clinical features or conditions that may have some prognostic significance in HIV infected individuals.

Keywords: HIV= Human Immunodeficiency Virus, AIDS = Acquired Immune Deficiency Syndrome, CD4+ count = Cluster of differentiation..