title: Evidence for lower CD4+ T cell and higher viral load in asymptomatic HIV-1 infected individuals of India: implications for therapy initiation.
abstract: OBJECTIVE
  We have earlier documented that the south Indian population had lower CD4 counts. The aim of this study was to investigate a previous suggestion on a new CD4+ T cell cut off and association with HIV-1 RNA levels for decision on anti retroviral therapy in India (south).
  
  
  METHODS
  We evaluated a new methodology i.e., artus real-time PCR and CD4+ T cell count by Guava EasyCD4 system. From 146 HIV infected individuals seen at a tertiary care centre, blood was collected for CD4+ T cell and HIV-1 RNA estimation.
  
  
  RESULTS
  The receiver operating characteristic curve cut off value for the CD4 counts to distinguish between CDC clinical categories A and B was 243 cells/microL, and to distinguish B and C was 153 cells/microL. The RNA level that differentiated CDC A and B was 327473 RNA copies/mL, while for CDC B and C was 688543 copies/mL. There was a significant negative correlation (r = -0.55, P + T cell counts in HIV infected individuals.
  
  
  CONCLUSIONS
  A majority with CD4 counts of 201-350 cells/microL in our population had higher viral load than the treatment threshold suggested by the International AIDS society and the above two methodologies are useful in monitoring HIV infections.
authors.affiliation: Department of Clinical Virology, Christian Medical College, Vellore- 632 004, India. rajeshkannangai@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Kannangai
authors.forename: A J
authors.initials: AJ
authors.lastname: Kandathil
authors.forename: D L
authors.initials: DL
authors.lastname: Ebenezer
authors.forename: G
authors.initials: G
authors.lastname: Nithyanandam
authors.forename: P
authors.initials: P
authors.lastname: Samuel
authors.forename: O C
authors.initials: OC
authors.lastname: Abraham
authors.forename: T D
authors.initials: TD
authors.lastname: Sudarsanam
authors.forename: S A
authors.initials: SA
authors.lastname: Pulimood
authors.forename: G
authors.initials: G
authors.lastname: Sridharan
mesh_terms: D018791:CD4 Lymphocyte Count / Q000379:methods; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification*; D006761:Hospitals; D006801:Humans; D007194:India; D016133:Polymerase Chain Reaction / Q000379:methods; D012367:RNA, Viral / Q000097:blood; D012372:ROC Curve; D012720:Severity of Illness Index; D019562:Viral Load
chemical_list: D012367:RNA, Viral