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Quantification of human immunodeficiency virus-1 viral load and its correlation with CD4 cell count in antiretroviral therapy naïve patients attending regional institute of medical sciences hospital, Imphal

Background: While the CD4 cell count plays a pivotal role for antiretroviral therapy (ART) initiation, plasma viral load (PVL) provides additional guiding information, especially in patients with a relatively high CD4 cell count. This study was carried out to quantify PVL and CD4 cell count in ART naïve cases and determine their correlation. Materials and Methods: A cross-sectional study was conducted on 82 ART naïve patients of ≥15 years of age attending the Fluorescent Activated Cell Sorter Count (FACSCount) center, Department of Microbiology at a tertiary care center after the Institutional Ethics Committee approval, from August 2014 to November 2015. Blood samples were collected after obtaining written informed consent. PVL was quantified by COBAS® TaqMan® human immunodeficiency virus type 1 (HIV-1) version 2.0 Test and CD4 cell count was measured by FACSCountTM System. The correlation analysis was performed by Pearson's correlation test (r) using SPSS 16.0 software. Results: In this study, mean PVL and CD4 cell counts were 108,000 ± 206,200 copies/mL and 348.2 ± 296 cells/μL, respectively. Among those with PVL ≥50,000 copies/mL, CD4 cell count was >350 cells/μL in 10.4%. PVL was not detectable in 8.5%. There was significant negative correlation (r = −0.54, P < 0.00) between PVL and CD4 cell count in ART naïve patients. Conclusion: Consideration of PVL in ART initiation guidelines for those with CD4 cell count >350 cells/μL will maximize ART coverage of highly infectious ART naïve patients, which in turn will reduce the risk of HIV transmission at individual and population level.