Estimating the time period between infection and diagnosis based on CD4+ counts at first diagnosis among HIV-1 antiretroviral naive patients in Nigeria
Estimating the time period between infection and diagnosis based on CD4+ counts at first diagnosis among HIV-1 antiretroviral naive patients in Nigeria
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DOI：
10.3855/jidc.1015
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发表时间：
2010-10-01
影响因子：
1.9
通讯作者：
Agwale, Simon M.
中科院分区：
文献类型：
--
作者：
Forbi, Joseph C.;Forbi, Thanda D.;Agwale, Simon M.
简介：CD4(+) T 细胞水平是对 HIV 相关临床病症进行分类的重要标准。感染的晚期诊断会导致不良的医疗结果和病毒传播的持续。这项在尼日利亚中北部进行的基于人群的队列研究报告了首次 HIV 诊断时的初始 CD4(+) 淋巴细胞计数，并确定了获得 HIV 感染的大致时间间隔。方法：已知首次 HIV 诊断日期的确诊 HIV-1 感染者 (n = 588) 被纳入本研究。使用荧光激活细胞分选仪（FACS）平台测量CD4（+）淋巴细胞计数，该平台自动将CD4（+）淋巴细胞定量为每μL血液中淋巴细胞的绝对数量。 HIV 感染和首次 HIV 诊断时间之间的估计时间间隔被确定为每年 CD4(+) 淋巴细胞衰减率的函数。 结果：结果显示，22.1% 和 49.7% 的 HIV 感染者晚期时分别出现晚期（CD4(+)：200-349 个细胞/μL）和严重（CD4(+)：< 200 个细胞/μL）免疫抑制，而仅12.1% 的患者 CD4(+) 为 500 个细胞/μL，16.2% 的患者 CD4(+) 为 350-499 个细胞/μL。与男性相比，女性的平均 CD4(+) 计数较高 (p > 0.05)。从感染 HIV 到首次诊断的时间间隔，男性约为 6.1 年，女性约为 7.3 年。结论：大多数 HIV 感染者这项研究中的个体在感染后期才获得医疗保健，这表明尼日利亚许多艾滋病毒感染者并不知道自己的艾滋病毒状况。迫切需要更有效的艾滋病毒早期诊断计划以防止传播。
Introduction: CD4(+) T-cell levels are an important criterion for categorizing HIV-related clinical conditions. Late diagnosis of infection contributes to poor medical outcomes and the continuation of viral transmission. This population-based cohort study in north central Nigeria reports the initial CD4(+) lymphocyte counts at the time of first HIV diagnosis and determines the approximate time interval when HIV infection was acquired..Methodology: Confirmed HIV-1 infected individuals (n = 588) for whom the dates of first HIV diagnosis were known were enrolled in this study. CD4(+) lymphocyte counts were measured using a Fluorescence Activated Cell Sorter (FACS) platform that automatically quantifies CD4(+) lymphocytes as absolute numbers of lymphocytes per mu L of blood. The estimated time interval between HIV infection and time of first HIV diagnosis was determined as a function of the CD4(+) lymphocytes' decay rate per calendar year.Results: The results showed that 22.1% and 49.7% of HIV-infected individuals present late with advanced (CD4(+): 200-349 cells/mu L) and severe (CD4(+): < 200 cells/mu L) immunosuppression respectively, while only 12.1% present with CD4(+) 500 cells/mu L and 16.2% with CD4(+) between 350-499 cells/mu L. Mean CD4(+) counts for females were higher when compared to those of males (p > 0.05), The time interval between HIV infection and first diagnosis was approximately 6.1 years for males and 7.3 years for females.Conclusion: The majority of HIV-infected individuals in this study accessed health care at late stages of infection, suggesting many HIV-infected individuals in Nigeria are unaware of their HIV status. More efficient programs for early diagnosis of HIV to prevent transmission are urgently required.