Download I2333612009

ABSfRACT.
Human immunodeficiency virus (HlV-1) viral load level were monitored, through extraction of
blood plasma from HIV-1 positive individuals of age between five years and seventeen years
old, in Nyumbani diagnostic Laboratory, the correlation ofCD4 count and viral load was also
recorded in accordance to the age. The study involved sampling 34 patients from the clinical
study who had plasma and PBMC specimen collected upon entrance into the study that
specimens had been stored appropriately and were available for testing. The HlV -1 RNA
SUBstudy meluded 17 random selected patients from the drug study who had plasma specimen
collected on the entrance into the study and whose specimen had been stored appropriately and
were ready and available for testing. The patients undergoing anti-retroviral therapy took various
variety of antiviral drugs depending on the age and the such drugs included: Zidovudine
(ZDV),Nelfinafir (NFV), Stavudine(d4T), and Efavirenz (TDF) which was also recorded to
analyze the response of the immune system with different ages ofHlV -1 positive individuals,
Infectious HlV in the plasma was cultured by inoculation into activated peripheral blood
mononuclear cells (PBMC) with serial dilution of plasma specimen. Quantitative culture had
limited utility for monitoring virus level in infected individuals since only a small fraction of
virus particle is infectious in vitro. Infectious virus is often undetectable in asymptomatic
individuals. The data shows that in population of patients with advance HlV-l disease and
undergoing specific anti-reverse transcriptase therapies, 5-fold higher baseline HlV-1 RNA
levels are associated with the increased risk of the disease progression. For patients who have
had greater than 16 weeks of prior ZDV therapy, 5-folds higher baseline mv-1 RNA therapy, 5fold changes between baseline and 8 weeks RNA levels have statistically significant prognostic
value. For patients who have had greater than 16 weeks of prior (ZDV) therapy, 5-fold changes
between baseline and the Week 8 RNA levels was identified, to be of significant prognostic
value. The frequency of disease progression was also analyzed for each study by dividing each
study population into deciles by rank order of base line HIV-l RNA. The deciles were evaluated
for the frequency of disease progression of 60% was found for all patients with baseline HlV-1
RNA level above 250,000 copies/ml, the study approximated 35 % frequency of the disease
progression was found for patients in the first four deciles « 11,912, <34,661, <72, 438, and
<103, 806 Hlv-I RNA copieSlmJ) with corresponded reduction of CD4+ count cells respectively.
Ten patients were recorded to be using Zidovudine (mV) which was the most used antiretroviral
drug by all individuals at a particular age, which is classified in a group ofNsRTIs (NonNucleoside reverse transcriptase inhibitors), followed three patients undertaking Nelfinafir
(NFV) of the antiviral chemotherapeutic drugs class of PIs (Protease Inhibitors), Stavudine(d4T),
the class ofNsRTIs antiviral drugs, and also two patients undertaking Efavirenz (TDF)