EVALUATION OF VIRAL LOAD, CD4 T LYMPHOCYTE COUNT, eGFR, COMPLETE BLOOD COUNTS AND VITAMIN D METABOLISM PARAMETERS IN HIV-INFECTED PATIENTS AT THE TIME OF DIAGNOSIS

Introduction: Kidney, liver and heart disease have become the leading cause of death rather than infections in HIV-infected patients. We aimed to investigate the relationship between HIV related results and other laboratory variables at the time of diagnosis. Material and Methods: Patients with viral load below 100.000 copies/ml were in group-1; patients with viral load above 100.000 copies/ml were in group-2. Patients were also staged according to their CD4 T lymphocytes count. Results: A sum of 292 naïve HIV positive patients were enrolled in the study. HIV viral load was positively correlated with creatinine and alkaline phosphatase levels, negatively correlated with eGFR, CD4+ T lymphocyte count, CD4+ T lymphocyte percentage, platelet, hemoglobin and hematocrit levels. HIV viral load was independently associated with CD4+ T lymphocyte percentage in logistic regression analysis (odds ratio, 0.937; 95% confidence interval, 0.896 to 0.981; p=0.005). CD4 positive T lymphocyte counts was found negatively correlated with age, HIV viral load and ALP levels; positively correlated with serum leucocyte levels, lymphocyte levels, platelet levels, hemoglobin levels, hematocrit levels, calcium levels, phosphorus levels and vitamin D levels. Conclusion: Initial evaluation of HIV-infected patients must include possible organ involvement parameters such as urea, creatinine, complete blood counts and parameters those associated with vitamin D metabolism in addition to CD4 T lymphocytes counts and HIV viral load.

HIV İLE ENFEKTE OLAN HASTALARDA TANI SIRASINDA VİRAL YÜK, CD4 T LENFOSİT SAYISI, eGFR, TAM KAN SAYIMI VE D VİTAMİN METABOLİZMA PARAMETRELERİNİN DEĞERLENDİRİLMESİ

Giriş: Böbrek, karaciğer ve kalp hastalıkları HIV ile enfekte hastalarda enfeksiyonlardan ziyade önde gelen ölüm nedeni haline gelmiştir. Tanı anında HIV ile ilgili sonuçlar ile diğer laboratuvar degişkenleri arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntem: Viral yükü 100.000 kopya/ml’nin altında olan hastalar grup-1’de; 100.000 kopya/ml’nin üzerinde viral yükü olan hastalar grup-2’de yer aldı. Hastalar ayrıca CD4 T lenfosit sayılarına göre evrelendirildi. Bulgular: Çalışmaya toplam 292 yeni tanı HIV pozitif hasta dahil edildi. HIV viral yük: eGFR; CD4 T lenfosit sayısı, CD4 T lenfosit yüzdesi, trombosit, hemoglobin, hematorit seviyeleri ile negatif; kreatinin ve alkalen fosfataz seviyeleri ile pozitif korelasyon gösterdi. HIV viral yükü, lojistik regresyon analizinde CD4 T lenfosit yüzdesi ile bağımsız olarak ilişkilendirildi (olasılık oranı, 0.937, %95 güven aralığı, 0.896-0.981; p=0.005). CD4 T lenfosit sayıları: yaş, HIV viral yükü ve alkalen fosfataz seviyeleri ile negatif; lökosit, lenfosit, trombosit, hemoglobin, hematokrit, kalsiyum, fosfor ve D vitamin seviyeleri ile pozitif korelasyon gösterdi. Sonuç: HIV ile enfekte hastaların ilk değerlendimesi, CD4 T lenfosit sayıları ve HIV viral yüküne ek olarak üre, kreatinin, hemogram ve D vitamini metabolizması ile ilişkili parametreler gibi olası organ tutulumu parametrelerini içermelidir.

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