Virological and immunological profile of HIV patients on first-line antiretroviral therapy in north central Nigeria: a retrospective study

Background and Objectives: The use of Highly Active Antiretroviral Therapy (HAART) has dramatically improved the quality of life and overall survival of HIV patients. UNAIDS has set a target of viral suppression for 90% of those treated by 2020 in order to end the HIV epidemic. We set out to determine patients’ virologic and immunological response after medium term first-line ART. Methods: This retrospective study was done between April 2017 and May 2018 at the AIDS Prevention Initiative in Nigeria (APIN)-supported HIV clinic of the Jos University Teaching Hospital (JUTH), north central Nigeria. Included in this analysis were patients who had been on either TDF/FTC/EFV or AZT/FTC/NVP consistently for at least 12 months and who had at least 95% adherence based on pharmacy drug pick up. Data were analysed using SPSS version 23.0. Results: A total of 301 patients who met the inclusion criteria were studied of which 187 (62.1%) were females and the overall mean (SD) age was 40±9 years. There were 204 (67.8%) patients on AZT/FTC/NVP while 97 (32.2%) were on TDF/FTC/EFV. Overall, the CD4 count increased from a median (IQR) baseline of 201 cells/mm3 by the end of 12 months of HAART. Or was it 24 months you used? (112–284) to 488 cells/mm3 by the end of 12 months of HAART (344.5–628.0) P = <0.001. Their overall virological suppression was 86.7%, but was higher for the TDF/FTC/EFV arm 92.8% compared to the AZT/3TC/NVP arm 83.8% (P = 0.03). Conclusion: Overall, there was good virologic suppression and immunological response of patients on first-line ART. This suggests that with good adherence the UNAIDS target of viral suppression for 90% of those treated is achievable.