European Journal of Biomedical and Pharmaceutical Sciences

HAEMATOLOGICAL AND INFLAMMATORY BIOMARKER DYSREGULATION AMONG PEOPLE LIVING WITH HIV BEFORE AND DURING ANTIRETROVIRAL THERAPY: A COMPARATIVE STUDY AT SHANAHAN UNIVERSITY TEACHING HOSPITAL, WATERSIDE, ONITSHA, NIGERIA

Odo V. C., Ebugosi R. S., Achara I. N.

ABSTRACT

The introduction of antiretroviral therapy (ART) has transformed human immunodeficiency virus (HIV) infection from a life-threatening illness into a chronic manageable condition. However, prolonged survival has been accompanied by increasing recognition of non-AIDS comorbidities, including metabolic disorders, cardiovascular disease, obesity, dysglycaemia and chronic systemic inflammation. This study compared selected haematological and inflammatory biomarkers packed cell volume (PCV), total white blood cell (WBC) count, CD4+ T-cell count and C-reactive protein (CRP)—among HIV-negative controls, HIV-positive participants who had not commenced ART, and HIV-positive participants receiving ART at Shanahan University Teaching Hospital, Onitsha, Nigeria. A comparative hospital-based study involving 120 participants, comprising three groups of 40 participants each, was conducted. The study groups were: HIV-negative controls, HIV-positive participants not receiving ART, and HIV-positive participants receiving ART. PCV, WBC count, CD4+ T-cell count and CRP were determined using standard laboratory procedures. Differences among the three groups were evaluated using analysis of variance (ANOVA), with statistical significance set at p < .05. Mean PCV values were 0.44 ± 0.03, 0.42 ± 0.02 and 0.44 ± 0.03 for controls, HIV-positive participants not receiving ART and HIV-positive participants receiving ART, respectively. Mean WBC counts were 6.53 ± 0.48 × 10⁹/L, 5.13 ± 0.18 × 10⁹/L and 6.22 ± 0.60 × 10⁹/L, respectively. Mean CD4+ T-cell counts were 1,149.00 ± 132.22, 548.75 ± 145.61 and 644.75 ± 118.07 cells/μL, respectively. Mean CRP concentrations were 1.10 ± 0.48, 2.85 ± 6.53 and 3.41 ± 1.56, respectively. Thus, compared with controls, HIV infection was characterized by a substantial reduction in CD4+ T-cell count and WBC count, together with increased CRP. ART-treated participants demonstrated partial recovery of WBC and CD4+ T-cell counts but retained elevated CRP concentrations. PCV showed little variation between groups Conclusion The findings demonstrate persistent immunological and inflammatory dysregulation among HIV-positive individuals, including those receiving ART. The increase in CRP despite improvement in CD4+ T-cell and WBC measures suggests that restoration of immunological status with ART may not necessarily coincide with complete resolution of systemic inflammation. These findings are consistent with contemporary evidence that residual inflammation may persist during treated HIV infection and contribute to long-term cardiometabolic morbidity. However, the present biomarkers do not directly establish insulin resistance. Future studies at this centre should incorporate fasting glucose, fasting insulin, HOMA-IR, HbA1c, lipid profile, anthropometric indices and HIV viral load to directly characterize the relationship between insulin resistance, ART exposure and chronic inflammation.

Keywords: HIV; antiretroviral therapy; CD4 count; C-reactive protein; white blood cells; packed cell volume; inflammation; metabolic dysregulation; insulin resistance; Nigeria.