Prevalence of Discordant Immune Response in People with HIV1 Infection and Correlation Between Age, Gender and CD4 Levels.

Abstract

Introduction: Discordant immune response (DIR) in patients with HIV1 infection on Antiretroviral Therapy (ART) results in high incidence of mortality. Additionally, little is known about the influence of age and gender on CD4 cell levels and the prevalence of DIR. Hence a study was undertaken to determine the prevalence of DIR in Indian HIV/AIDS outpatient department and study effect of age and gender on DIR in people with HIV-1 infection on ART to facilitate early intervention and implementation of better treatment strategies.

Objectives: To study the prevalence of Discordant Immune Response of patients with HIV 1 infection.

Methods: A retrospective chart review was undertaken to explore the prevalence of DIR, by reviewing the records of patients with HIV 1 infection visiting the ART clinic in a tertiary care hospital during the period of April 2021-April 2023. Demographic data (age, gender) and values of CD4, CD8 and Viral Load tests were entered in a password protected computer for analysis.

Results: Out of 1509 individuals who were tested for CD4 and Viral Load, 154 individuals were identified as immunologically discordant. The prevalence of immunological discordance to ART was 10.02%. Higher prevalence was seen in males and in people above 60 years. A weak negative correlation was observed between age and CD4 level in people with concordant immune response, however there was no significant correlation found in patients having discordant immune response.

Conclusions: Prevalence of DIR in patients with HIV1 infection was 10.2% in Navi Mumbai, Maharashtra. This study highlights the complexity of achieving full immune recovery in HIV patients and the need for targeted approaches beyond viral suppression.