Association of CD4 cell count and antiretroviral therapy antibody production in Human Immunodeficiency virus seropositive subjects on antiretroviral drugs in Benin City, Nigeria.

Abstract

Antiretroviral therapy (ART) is widely used and subjects on ART were reported to develop antibodies against these drugs when used as monotherapy. The aim of this study was to determine the proportion of HIV-sero positive subjects on antiretroviral therapy who developed antibodies to the drugs used as combination therapy and to associate the presence of antibodies to CD4 cell count which is a marker of disease progression. A total of 300 subjects were randomly selected for the study, consisting of 100 HIV-sero positive subjects already on ART, 100 newly diagnosed HIV-sero positive ART-naive subjects and 100 HIV-sero negative individuals who were monitored as controls. CD4 cell count and complete blood count were assayed using BD FASCOUNT CD3/CD4 and Sysmex KX-21N autoanalyzer respectively. Antigen-Antibody agglutination technique was used to detect antibodies produced against antiretroviral drugs in HIV -sero positive subjects on ART. The results showed that antibodies to antiretroviral drugs (tenofovir disoproxil fumarate/lamivudine Efavirenz + lamivudine/ nevirapine/zidovudine combination) were detected in 33(33%) out of the 100 HIV-sero positive subjects on ART studied. Significantly higher CD4 cell count (p<0.001), PCV (p<0.001) and white blood cell count (p<0.001) were recorded among control group than HIV positive subjects whether they were on ART or not. However, a significantly lower level of platelet was observed in HIV-sero positive subjects on ART who developed antibodies. The findings from this study showed that antibody to antiretroviral drugs was detected in 33(33%) out of the 100 HIV- sero positive subjects on ART combination studied.  The use of combination therapy has led to a smaller number of subjects on ART who developed antibody as against a higher percentage on monotherapy that was previously reported. Significantly lower level of platelet was observed among HIV-sero positive subjects who developed ART antibodies.