Relationship of plasma viral load, CD4+ lymphocyte count and clinical manifestations in HIV infected patients

Nino Gochitashvili, Tengiz Tsertsvadze, Lali Sharvadze, Pati Gabunia, Manana Gvaberidze,
Lela Dzigua

Infectious Diseases, AIDS & Clinical Immunology Research Center, Tbilisi, Georgia

Objectives: To assess the relationship between the viral load (level of Human Immunodeficiency virus type – 1 (HIV - 1) RNA in plasma), CD4 count and clinical manifestations in Georgian HIV infected patients. Materials and Methods: a total of 82 adult HIV infected antiretoriviral naive patients were studied into the prospective cross-sectional study. Patients were divided into the three groups by the viral load level: 1st group – 22 patients with low level of viral load (<10,000 copies/ml), 2nd group – 17 patients with medium level of viral load (between 10,000 – 100,000 copies/ml) and 3rd group 42 patients with high level of viral load (>100,000 copies/ml). Viral load was tested by Polymerase Chain Reaction (PCR) and CD4+ lymphocyte count was detected by Immunofluorescent technique. Results: 1st group: mean value of viral load - 3835 copies/ml (range undetectable - 9983), mean value of CD4 count - 572 cells/l (range 378 - 889). Among this group asymptomatic patients and patients with Persistent Generalized Lymphadenopathy (PGL) predominated (category A by CDC classification of 1993). 2nd group: mean value of viral - 40765 copies/ml (range 12789 - 98437), mean value of CD4 count - 451 cells/ml (range 231 - 721). Among the patients of this group 10 patients were asymptomatic or presented with PGL (category A) and the other 7 were symptomatic (category B or C by CDC classification of 1993). 3rd group: mean value of viral load - 547801 copies/ml (range 106734 - 1754342), mean value of CD4 count - 150 cells/ml (range 23 - 457). Majority of this group patients were presented with advanced stage of HIV disease (category B or C). Conclusions: There was a significant correlation between the increased viral load, decreased CD4 count and presence and severity of clinical manifestation of HIV infection.

Keywords:  HIV, plasma HIV RNA, CD4+ lymphocyte count, viral load, clinical manifestations