Rajesh Kumar, G (2012) A Real-Time PCR Based Study on HIV Viral Load and Its Correlation with the Clinical and Immunological Status of the HIV Positive Patients. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : H I V infection/AIDS has become a major public health problem in India. Although the median interval between HIV-1 infection and the development of the Acquired Immune Deficiency Syndrome in adults is 10 to 11 years, some infected persons rapidly progress to AIDS in less than five years. The biological basis of this variability is unknown but differences in viral strains, host immune response and exposure to microbial or environmental factors probably contribute. Identification of laboratory tests that help predict the progression to AIDS in people infected with HIV is desirable because of its implication for both clinical management and prognosis. Quantitative measurement of HIV RNA levels in peripheral blood has contributed significantly to the understanding of the pathogenesis of HIV infection and has been shown to be an essential parameter in the prognosis and optimal management of HIV infected individuals. CD4+ T cell count is the laboratory test generally accepted as the best indicator of the immediate state of immunologic competence of the patient with HIV infection.It has been shown to correlate very well with the level of immunologic competence of the patient. In view of above, this study was taken to determine the clinical profile, immunological and virological status of the HIV seropositive patients. AIM : To determine the clinical,virological and immunological status of HIV positive patients who attend Institute of Venereology and ART Centre at Madras Medical College, Chennai. MATERIALS AND METHODS : Study design: Cross sectional study. Study period: May 2010 - August 2011. Subject Selection: 50 treatment naive HIV positive patients diagnosed at Institute of Venereology and ART Centre at Madras Medical College, Chennai were randomly selected for the study. Inclusion Criteria: • Patients who were positive for HIV infection. • Patients who were at the various stages (WHO staging) of HIV disease. Exclusion criteria HIV positive patients who were on ART. Study: Patients selected for study were subjected to detailed clinical history,examination and necessary routine laboratory investigations. Clinical staging was done according to the WHO clinical staging for AIDS. At recruitment, blood samples were taken from all the patients in a plain vial for serum HIV testing and EDTA vacutainer for whole blood CD4 cell count and plasma viral load determination after obtaining informed consent. Laboratory methods: Serodiagnosis of HIV infection will done by Test 1 –RETROCHECK, Test 2- SD BIOLINE HIV ½ 3.0, Test 3- COMBAIDS. Strategy used: Strategy 3. • Absolute CD4 lymphocyte count determined by Flow cytometry. • Viral load done using Real-Time PCR : Real-Time PCR based HIV Assay was standardized and done by HELINI Biomolecules. CONCLUSION : In this study the most common risk factor elicited was heterosexual high risk behavior. Injection drug abuse and mother to child transmission was also observed. • The most common presentation was various dermatoses followed by upper respiratory tract infections and cachexia. • Oral candidiasis was the most common mucocutaneous manifestation observed. • There was a strong correlation between increased frequency of opportunistic infections and low CD4 count. • Tuberculosis was found to be more common when CD4 count is less than 350 cells /μl. • There was strong correlation between the worsening stage of the disease and decreasing CD4 count. • Stage 1 HIV infection had very high viral load may be because most of the patients were in their earliest part of the Stage 1 disease. A relatively high CD 4 count was observed in these patients. • Stage 4 showed a very high viral load and a very low CD 4 count which is well correlated with the pathogenesis of the disease. • Stage 2 and 3 had significantly low viral load and a declining CD 4 count.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Real-Time PCR Based Study ; HIV Viral Load ; Clinical and Immunological Status ; HIV Positive Patients. |
| Subjects: | MEDICAL > Dermatology Venereology and Leprosy |
| Depositing User: | Subramani R |
| Date Deposited: | 01 Mar 2018 17:13 |
| Last Modified: | 03 Mar 2018 07:13 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5950 |
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