Association of opportunistic infections with HIV-RNA and CD4 cell count in pre ARV and ARV failure at the care support treatment clinic of Sanglah hospital, Bali

ABSTRACT An examination for HIV RNA (viral load) prior to Antiretroviral (ARV) administration is necessary to assess the level of virus in the serum, which has an impact on how rapidly the disease will progress. HIV RNA measurements are also important to detect early therapy failure. To date, HIV RNA examination has not been performed for both pre-ARV and ARV failure patients in Indonesia. Therefore, we performed a study to assess the level of HIV RNA in pre-ARV and ARV failure patients, and evaluated the association between HIV RNA level, CD4 count, and the types of opportunistic infections. This is a cross sectional study of 40 pre-ARV and 35 ARV failure patients. In these pre-ARV and ARV failure patients, the mean level of HIV RNA were 389,394 (SD 287,913) and 163,705 (SD 218,681) copies/ml, while the CD4 counts were 73 (SD 97) and 50 (SD 94) cells/mm3 respectively. In pre-ARV patients, the mean CD4 count in subject with TB and without TB was significantly different (14 [SD 12] vs. 92 [SD 105] cells/mm3). The HIV RNA level in pre-ARV patients with wasting syndrome is higher than that of patients without wasting syndrome (556 [SD 286] vs. 340 [SD 274] copies/mm3), while in the ARV failure patients, HIV RNA level is higher in subject with toxoplasma infections than those without wasting syndrome (525 [SD 255] vs. 129 [SD 185] copies/mm3). There was an association between few opportunistic infections and HIV-RNA level and CD4 cell count in patients at the clinic of Sanglah Hospital, Bali. KeyWords: HIV RNA, Viral load, CD4, Opportunistic infection, Bali