Correlation between CD4 Count and HIV-1 Viral Load among ART Naive Patients Attending ICTC, SMS Medical College, Jaipur

Objectives: To study the correlation between CD4 count &HIV-1 viral load among ART Naive patients attending ICTCSMS Medical College, Jaipur.Material and Methods: This study was conducted on 250 HIVserologically confirmed, ART Naive cases from ICTC, SMSJaipur. RNA extraction was done from plasma samples byQiagen Viral RNA Mini Kit then HIV-1 Viral load wasdetermined by Qiagen HIV-1 viral load kit on ABI 7500 Fast dxReal Time PCR, while CD4 count was done on FACSCALIBUR flowcytometer (BD Biosciences). SPSS ver. 21.0was used to determine correlation between CD4 count & HIV-1viral load.Results: Out of 250, 216 (86.4%) cases were found in whichviral RNA was detected. These samples were correlated withtheir CD4 Count. The mean of viral load was 194746.2791 ±550442.61805 IU/ml while CD4 count was 282.7674 ±217.56456 cells/ul. Females were having Avg. Viral load228506.7273 & CD4 count 337.21 and males were found tohave Avg. Viral load 179791.9866 & CD4 count 258.65Conclusion: This study concluded a negativecorrelation between HIV-1 RNA viral load and CD4 count inHIV-seropositive ART naïve patients of this part of the country.Our study confirmed that HIV-1 RNA viral load levels aresignificantly higher in women than in men, but no suchsignificant gender difference in the CD4 count was found.

Incidence of Seropositive But HIV-1 Viral RNA Not Detected Naive Cases In Rajasthan

Objectives: To identify cause of HIV seropositive but ViralRNA undetected naive cases in Rajasthan.Materials and Methods: This study included 250 HIV seropositive cases from ICTC Centre, SMS Jaipur .HIV Viral loadwas done by Qiagen HIV-1 viral load kit on ABI 7500 Fast dxReal Time PCR, while CD4 count was done on FACSCALIBUR flowcytometer (BD Biosciences).Results: A total of 250 HIV Serological confirmed positivesamples were tested for HIV-1 RNA viral load & CD Count inthe period of 2014-19. Out of 250, 26 (10.4%) cases werefound in which viral RNA were undetected. out of 26seropositive but HIV RNA undetected case, 16(61.5%) wereMale while 10 (38.5%) were females. Mean of CD4 in Femalewas 565 while 650 in males.Conclusion: HIV‑1 seropositive patients but undetected viralload is not uncommon in society. HIV sero-positive but viralRNA undetected males CD4 count were higher than females. Itwas also observed that all the cases of seropositive withundetected viral load had higher CD4 count comparative withseropositive with viral RNA detected patients. It is concludedthat RNA viral load test is a prognosis test, although suchpatients who had seropositive but viral load undetected needfurther investigations after 3-4 weeks to monitor the status ofthe disease

Comparison of MGIT 960 & pyrazinamidase activity assay for pyrazinamide susceptibility testing of Mycobacterium tuberculosis.

Background & objectives: Pyrazinamide is an important front line antimycobacterial drug, which is also being used in the treatment of multi drug resistant tuberculosis along with second line drugs in DOTS plus programme. Conventional testing of pyrazinamide on solid medium is difficult as it is active at acidic pH. Therefore, there is a need for a rapid and simple method for susceptibility testing of pyrazinamide. This study was carried out to compare pyrazinamide susceptibility testing by MGIT 960 and two rapid pyrazinamidase activity tests. Methods: Pyrazinamide susceptibility was tested in 136 clinical isolates of Mycobacterium tuberculosis by MGIT 960 and pyrazinamidase activity was tested by classical Wayne’s method and modified PZase agar method. Results: There was 88.9 per cent concordance between MGIT 960 and classical Wayne’s method and 93.38 per cent with modified method for pyrazinamidase activity. Using MGIT 960 results as gold standard the sensitivity and specificity of Wayne’s method was 88.15 and 90 per cent respectively and that of modified method was 89.4 and 98.3 per cent. Interpretation & conclusions: Our study demonstrates that the modified pyrazinamidase activity test can be used as a screening test to detect resistance to pyrazinamide specially in resource limited settings but confirmation of susceptibility should be done by standard methods like MGIT 960.

Transport and storage of sputum specimen by using cetylpyridinium chloride for isolation of mycobacteria.

Of the 191 sputum specimens that were collected from pulmonary tuberculosis patients, 78.65% (140/178) specimens were culture positive when processed within 48 h by the NaOH method. The culture positivity in the same specimen that were stored with cetylpyridinium chloride (CPC) and processed after 7-8 days was 70.22% (125/178), whereas those stored without CPC and processed by the NaOH method was 46.62% (83/178). The difference in number of positive cultures obtained before storage and after storage (without CPC) was statistically significant (P = 0.001). Culture positivity by the CPC method was comparable with that of NaOH method before storage and the difference was not statistically significant (P = 0.35).