Abstract
VIRAL LOAD MONITORING AND FIBRINOLYTIC MARKERS IN HUMAN IMMUNODEFICIENCY VIRUS INFECTED PATIENTS ON ANTIRETROVIRAL THERAPY

Moore-Igwe B. W.*, Omunakwe H. E., Ibegbulem E. O., Eze E. N. and Jeremiah Z. A.

ABSTRACT

A study on Viral Load Monitoring and fibrinolytic markers in Human Immunodeficiency Virus patients on Antiretroviral Therapy (ART) was carried out to monitor the effect of therapy on these parameters. The study was carried out in three phases: Baseline sample collection, samples taken after three months of follow-up and samples taken after six months of follow-up with antiretroviral therapy. A total of forty (40) Antiretroviral therapy naive patients, of which 14 and 26 were males and females; age range of 20-45 years attending Rivers State University Teaching Hospital, Port Harcourt, were monitored for their viral load and fibrinolytic markers, within a follow up period of 6 months which included baseline, three months and six months. Viral load was determined using real time PCR and Enzyme Linked Immunosorbent Assay Technique were used for fibrinolytic markers. Data and statistical analysis were performed using S 9.4 Statistical analysis software (SAS Institute, Cary, NC, USA). P-value < 0.05 was recorded as significant for viral load, tissue plasminogen activator (tPA) and D-Dimer. Baseline viral load was 21476 ± 56914 cp/ml, after 3 month of ART it was 706 ± 108 cp/ml and 4-6 months of follow-up to 30 ± 3 cp/ml for a total of 100% overall decrease from baseline at the end of 6 months of follow-up. tPA increased 89% from baseline of 64.45 ± 6.85 ng/ml to 121.76 ± 6.64 ng/ml after 3 months of follow-up, but subsequently decreased by 45% to 67.38 ± 1.94 ng/ml between 4-6 months with a positive status of 3% increase attained at the end of 6 months from baseline. D-Dimer initially decreased sharply by 89% to 242.74 ± 52.87 pg/ml after 3 months follow-up from the mean baseline value of 2282.74 ± 325.68 pg/ml. This was followed by sharp and sudden increase of 462% increase to 1363.12 ± 209.14 pg/ml during the period between 4-6 months, with a resultant overall increase of 40% at the end of 6 months follow-up (Baseline-6 months). However, and Plasminogen activator inhibitor – 1 was low at baseline 10.84 ± 0.48 ng/ml with a significant elevation to 45.45 ± 3.47 ng/ml at 3 months of treatment and further increased to 77.56 ± 1.62 ng/ml at the end of 6 months. The findings from this study show that ART has an influence on the levels of tPA which may lead to a prothrombotic state in HIV on treatment.

Keywords: Viral Load, Fibrinolytic markers, Human Immunodeficiency Virus, Antiretroviral Therapy.


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