The prognostic validity of affordable alternative biomarkers in HIV infection

Abstract

Background-Human immunodeficiency virus (HIV) infection is a global pandemic with varying prevalence in Indian states. Since 2010, north-eastern states have seen an increase in infections, and by March 2023, 1.68 million individuals were on antiretroviral therapy (ART). Routine evaluations of haematological and biochemical markers are carried out, but there is a need for more research on substitute markers related to HIV pathogenesis, patient vulnerability, and treatment responses, particularly focusing on affordable biochemical variables as alternative prognostic indicators in developing countries like India.
Methods- This observational and cross-sectional study was conducted at the Sir J.J. Group of Hospitals, Grant Government Medical College, Mumbai, in the Department of Biochemistry. This study involved 150 HIV-positive participants and 50 controls, totalling 200 subjects. The HIV-positive participants were categorized based on CD4 counts into three stages: Stage I (?500 cells/?l), Stage II (201-499 cells/?l), and Stage III (?200 cells/?l) having 50 subjects each. Blood samples were collected for serum total protein and other investigations, and were stored at -20 °C for analysis using autoanalyzer.
Results- In our study we noted that biochemical markers such as serum total protein, A/G ratio, and haemoglobin showed statistically significant alterations in HIV group as compare to control group. In progressive stages based on CD4 count modifications with striking significant correlation were observed between CD4 count and serum total protein and haemoglobin.
Conclusion-In rural areas, government health systems struggle with CD4 count and viral load assays for HIV. There is an urgent need for low-cost alternative indicators to monitor HIV progression. Indicators such as serum total protein and haemoglobin could serve as inexpensive substitutes when CD4 count is under 499 cells/?l in stage II. Regular monitoring of these biochemical markers may be suggested to improve prognosis, manage co-morbidities, and lower mortality rates.