Hiv-1 Infection among Late Diagnosed Patients Accessing Antiretroviral Therapy in Jos, Nigeria

Abstract

Early diagnosis and estimation of duration of HIV-1 infection among the population is critical for public health intervention services in order to reduce risk associated with spreading of the virus. Over the years, reliable methods have been developed for estimating duration, and to differentiate early from late acquired HIV-1 infection. The cross-sectional study was carried out with newly enrolled patients at HIV treatment Centre of the Jos University Teaching Hospital. Avidity assay, viral load, CD4 cell count and WHO disease staging were used to characterize the patients. We described the socio-demographic, clinical and laboratory features of the study population. Of 230 patients, 90% had late and 10% early infection. The median age of the patients was 35 years, while the majority of the patients were female (64%). Median CD4⁺ cell count was significantly lower in those lately diagnosed (131 cell/mm3). Pulmonary tuberculosis (PTB) co-infected patients comprised 12%, 20% of oropharyngeal candidiasis, 25% of chronic diarrhea, and 59% had WHO clinical stage 3 or 4. In conclusion, late diagnosis is the most common presentation to tertiary healthcare facility, though this pattern is changing as a result of scale-up antiretroviral treatment. The analysis showed that HIV viral load, CD4⁺ cell counts, pulmonary tuberculosis co-infection and oropharyngeal candidiasis were significantly associated with late diagnosis of HIV infection. Therefore, there is need to intensify the present efforts on early routine HIV counseling and make ARVs available in all primary healthcare facilities in rural communities. This could reduce the frequency of late HIV diagnosis at tertiary institutions in order to avert AIDS condition.