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To correlate quantitative c-reactive protein with cd4 count in patients of hiv on art

Author: 
Dr. Anoop Yadav, Dr. Ranjeet Morya, Dr. Hemant Kumar Mahur, Dr. Dheeraj Mittal and Dr. Raghuvendra, G.
Subject Area: 
Health Sciences
Abstract: 

Introduction : The acquired immunodeficiency syndrome (AIDS), a disorder in which the immune system gradually fails and life-threatening opportunistic infections and malignancies proliferate, is brought on by the human immunodeficiency virus (HIV), a lentivirus (a member of the retrovirus family).Naturally C-Reactive Protein being an acute phase reactant should increase in patients with HIV disease progression if it is associated with microbial translocation and immune activation as hypothesized in studies.Many studies reported that there is a significant association of immune activation as measured by quantitative CRP levels with HIV disease progression.This study was designed to find the association between quantitative CRP and CD4 count in patients of HIV. Method:We retrieved and analyzed the data of 100 patients of HIV on ARTbetween June 2020 to December 2021 at Department of General Medicine and Outpatient Department or ART Centre, RNT Medical College and assigned group of Hospitals, Udaipur. Results :Majority of the subjects are on TLE (82%) regimen, followed by TLD (17%) and ZLN (1%).Majority patients had opportunistic infections and predominant was oral candidiasis (24%) followed by LRTI(17%), diarrhea (16%), tubercular meningitis(10%) and pulmonary TB(8%). 22% patients didn’t have any opportunistic infections. Among opportunistic infection as the severity of the infection increases, mean CRP levels among them increased, this shows positive correlation of mean CRP with severity of the infection statistically significant with p value = 0.000.Among opportunistic infection as the severity of the infection increases, mean CD4 levels among them decreased, this shows negative correlation of mean CD4 with severity of the infection, statistically significant with p value = 0.000. As the CD4 levels decrease, there is increase in CRP levels, so there is significant negative correlation between mean CD4 and mean CRP among subjects with different above labelled opportunistic infection.There is mean CRP of 22.52 mg/dl & Mean CD4 of 229.84 cells/cumm.As they both are negatively correlated and hence statistically significant with Pearson Correlation, r value – 0.770 p value = 0.000. Conclusion: Elevation of CRP is associated with a low count of CD4 in HIV diagnosed patients.Thus,serum CRP levels can be used as marker of immunosuppression and type of opportunistic infection in resource-limited areas where CD4 count availability is difficult.

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