मेडिकल माइक्रोबायोलॉजी और निदान

Biochemical Parameters in Human Immunodeficiency Virus Disease Progression

Abstract

Ramana KV, Ratna Rao, Sabitha, Venugopal B, Rafi MD and Sanjeeva Rao D

Human Immunodeficiency Virus (HIV) infection, with the complexity of disease and its progression has become a challenge to human beings. HIV infection leads to variable disease course in different people, amongst them are long term non-progressors, who survive more than 10 years after getting infected. Due to the chronicity of the disease and the extent of morbidity it causes, management of such individuals has become a challenge for physicians treating HIV infected patients. Traditionally HIV disease progression is monitored using TCD4+ cell counts and HIV/RNA viral load. Resource poor countries which cannot afford such expenses are looking forward to tests that can be done easily and are cost effective to monitor HIV disease progression and treatment response. We therefore evaluated certain biochemical parameters in both HIV seropositive treatment naive and those on HAART. Significant differences are observed in the plasma concentration of CK-MB (p<0.01), AST (p<0.05), LDH (p<0.01), Total Cholesterol: HDL ratio were (p<0.001), HDL:LDL ratio (p<0.001), A/G ratio (p<0.001), ALT (p<0.02), Serum Albumin (p<0.001), and Serum Globulin (p<0.001) levels. Serum albumin (r = -0.191), Albumin:Globulin ratio (r= -0.162), Total protein (r= -0.029), LDH (r= -0.264), CK/MB (r= -0.027), HDL (r= -0.0380 and LDL:HDL ratio (r= -0.032) were found negatively correlating with TCD4+ cell counts in HIV seropositive patients who are antiretroviral therapy naive. A paired t test of various parameters before and after HAART showed significant results with TCD4+ cells (p <0.0001), CK/MB ( p= 0.0451) and LDL:HDL ratio (p=0.0341). The results reemphasize the significance of evaluating certain biochemical parameters in HIV seropositive individuals and their usefulness in the management of disease progression and treatment response.