European Journal of Molecular & Clinical Medicine

Background: The benefits of Highly Active Anti-Retroviral Therapy (HAART) on mortality and morbidity in HIV-positive persons are well documented. The guidelines on When to start ART have evolved over the years towards earlier initiation of ART & present study was aimed to compare early versus late initiation of ART in PLHIV, in terms of effect on the CD4 counts and other laboratory parameters.
Material and Methods: Present study was prospective, observational study, conducted in patients ≥18 years, of either gender, recently diagnosed with HIV-1 infection or PLHIV, with CD4 count ~ 500cells/cu.mm & patients with CD4 count~350 cells/cu.mm.
Results: Enrolment of newly diagnosed clients for ART rose from 2.34 % in the L.I. group to 3.58% in the E.I. group & correlation was found to be statistically significant. In E.I group, median increase in CD4 count from baseline to 6 months was 119 cells/mm³ and from 6 months to 12 months was 57 cells/cu.mm. At 12 months of ART initiation, statistically significant deranged LFT, increased anemia was noted in the L.I group, as compared to E.I group. No statistically significant change in RFT, WBC count was noted.
Conclusion: Early initiation of ART was instrumental in a significant improvement as compared to Late Initiation of ART with regards to rise in CD4 counts at 6 & 12 months, improvement in LFTs, rise in Haemoglobin levels.

Background: Tuberculosis is among the most common opportunistic infections in people living with HIV/AIDS and is also the most common cause of peripheral lymphadenopathy. These lymph nodes revealed four different patterns on FNAC, which indirectly reflected the immune status in these people. CD4 counts, being a primary marker for immunological status in HIV people, were used to initiate ART, monitoring disease progression and management. The present study was aimed to correlate these four cytomorphological patterns with CD4 counts.
Results: In the present study we observed that CD4 counts varied significantly with different cytological patterns. Pattern 1, having a lower CD4 counts, reflects a poor immune response, whilst pattern 4, having higher CD4 counts reflected a better immune response.
Conclusion: FNAC patterns can be used to predict the CD4 counts where flow cytometry facilities for CD4 count estimation may not be available.

Globally, an estimated 10.0 million (range, 9.0-11.1 million) people fell ill with TB in 2018, a
number that has been relatively stable in recent years. The burden of disease varies
enormously among countries, from fewer than five to more than 500 new cases per 100 000
population per year, with the global average being around 130. The sputum samples were
treated with a sample reagent (SR) containing sodium hydroxide and isopropanol. The SR
was added to the sample in a ratio of 2:1 and incubated at room temperature for 15 min. The
treated sample is then manually transferred to the cartridge which is loaded into the
GeneXpert instrument. A printable test result was obtained after 1hour 45 minutes.
Considering the chief complaints at presentation, majority of patients (96%) had cough,
followed by fever in 40% cases, shortness of breath in 22%, hemoptysis in 6% and weight
loss in 6%.