title: Antiretroviral therapy, CD4, viral load, and disease stage in HIV patients in Saudi Arabia: a 2001-2013 cross-sectional study.
abstract: BACKGROUND
  The incidence of HIV/AIDS is increasing worldwide and in the Middle East. In this study, we analyzed the use of antiretroviral therapy (ART), the patterns of CD4 and viral load (VL), and stage of presentation.
  
  
  METHODS
  Laboratory variables, ART use, and CD4 count were obtained and analyzed retrospectively.
  
  
  RESULTS
  A total of 997 cases from eight HIV/AIDS care providers were included. Of the total cases, 274 (28.3%) had a CD4 count of < 200 cells/mm(3), and 413 (42.3%) had a viral load of > 5 log10. Of the total cases, 50% were on highly active antiretroviral therapy (HAART), and the majority of cases were asymptomatic (70%). Of those patients on ART, 247 (39.5%) took tenofovir/emtricitabine combined with either efavirenz (147; 14.7%) or lopinavir/ritonavir (100; 10%), and 158 (15.8%) were on lamivudine and zidovudine with either efavirenz (32; 3.2%) or lopinavir/ritonavir (126; 12.6%). Other combinations were used in 70 (7%) patients. The mean (± standard deviation) of baseline CD4 and viral load were 401 cells/mm(3) (322 cells/mm(3)) and 4.6 log10₁₀ (1.3 log10), respectively. At diagnosis, 72% of patients were asymptomatic; 50% had AIDS and 20% had CD4 count < 350.
  
  
  CONCLUSIONS
  ART use was in line with international guidelines, but the number of patients receiving ART was lower than expected. Large proportions of cases presented late with AIDS at diagnosis or had CD4 < 350. Further data is needed to evaluate the medical care of patients with HIV/AIDS in the Kingdom of Saudi Arabia.
authors.affiliation: Ministry of Health and College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia. zmemish@yahoo.com.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Memish
authors.forename: Jaffar A
authors.initials: JA
authors.lastname: Al-Tawfiq
authors.forename: Sanaa M
authors.initials: SM
authors.lastname: Filemban
authors.forename: Sayed
authors.initials: S
authors.lastname: Qutb
authors.forename: Abdullah
authors.initials: A
authors.lastname: Fodail
authors.forename: Batol
authors.initials: B
authors.lastname: Ali
authors.forename: May
authors.initials: M
authors.lastname: Darweeish
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents