Factors associated with long-standing HIV-1 infection among HAART treatment-naïve adults in Jos, Nigeria

Abstract

The estimation of the duration of HIV infection among newly enrolled HIV infected patients has become important because of clinical implications. Since many patients with HIV-1 infection are not usually diagnosed until they present with symptoms, the need to determine the factors associated with long-standing infection is becoming increasingly important for the epidemiologic purposes and of early access to HAART. We determine the factors associated with long-standing HIV infection in HAART naïve patients. One hundred and five cryopreserved plasma samples randomly selected from sample frame of 230 HIV-1 infected treatment-naïve patients at the adult ART clinic of the Jos University Teaching Hospital, were tested using enzyme immunoassay (EIA)-avidity index assay. Of the 105 samples, 100 were successfully tested. Basic demographic (age, sex, residence, education level, marital status), spouse on ARV, spouse HIV status), mode of transmission, WHO clinical staging, co-infections, HIV-1 viral load, and CD4+cell count results were obtained and analyzed using Stata software version 10.1. Majority of the patients had long-standing HIV-1 infection and were late presenters to the ART treatment Centre. Both the univariate and multivariate analyses showed that low CD4+ cell count was associated with the longstanding HIV infection at 95% CI 5.34 (1.30-21.92). Early detection of HIV-1 infection and access to ART is necessary to avoid rapid decline of CD4+ cell count resulting in accelerated HIV disease progression and consequent development of opportunistic infections.