title: Demographic and clinical correlates of HIV-1 RNA levels in antiretroviral therapy-naive adults attending a tertiary hospital in Jos, Nigeria.
abstract: BACKGROUND
  Plasma HIV-RNA viral load (VL) of HIV-infected persons is an important prognostic factor in HIV management. We determined the VL among antiretroviral therapy (ART)-naive patients to identify the association between patients' demographic, clinical and laboratory characteristics with VL.
  
  
  METHODS
  A cross-sectional study of 224 ART-naive HIV-1-infected patients (≥15 years of age) accessing care at the Jos University Teaching Hospital AIDS Prevention Initiative in Nigeria ART treatment centre, from October 2010 to April 2011. A log-linear model was used to determine if VL was related to demographic and clinical variables.
  
  
  RESULTS
  The patients had a median (interquartile range) age of 34 (28-41) years with females in the majority (59%). Females compared to males and pulmonary tuberculosis (PTB) co-infected compared to not co-infected patients had a significantly higher VL (14.9 logeversus 11.5 loge,P=0.003 and 11.31 logeversus 11.89 loge,P=0.047, respectively). VL tended to decrease with increasing CD4+ cell count levels in females, but remained relatively unchanged in males across all values of CD4+ cell counts. The difference (β) in the mean change in VL between males and females was loge0.64 copies/mL,P=0.005.
  
  
  CONCLUSIONS
  In ART-naive HIV-1-infected patients in our setting, females had significantly higher VL and lower CD4+ cell count, at the same VL threshold, compared to males, and hence were more likely to be at a higher risk of rapid progression to AIDS. Therefore, gender-based strategies for early identification and engaging females into care are required in this setting to mitigate against rapid progression to AIDS.
authors.affiliation: Department of Microbiology, University of Jos, Nigeria; AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Nigeria.
authors.forename: Joseph
authors.initials: J
authors.lastname: Anejo-Okopi
authors.affiliation: AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Nigeria; Department of Pharmacy, Jos University Teaching Hospital, Nigeria.
authors.forename: Isaac Okoh
authors.initials: IO
authors.lastname: Abah
authors.affiliation: Department of Zoology , University of Jos , Nigeria.
authors.forename: Yakhat
authors.initials: Y
authors.lastname: Barshep
authors.affiliation: AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Nigeria; Department of Pediatrics, University of Jos, Nigeria.
authors.forename: Augustine Odo
authors.initials: AO
authors.lastname: Ebonyi
authors.affiliation: AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Nigeria; Department of Medicine, University of Jos, Nigeria.
authors.forename: Comfort
authors.initials: C
authors.lastname: Daniyam
authors.affiliation: AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Nigeria; Department of Pediatrics, University of Jos, Nigeria.
authors.forename: Samson Ejiji
authors.initials: SE
authors.lastname: Isa
authors.affiliation: AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Nigeria; Department of Pediatrics, University of Jos, Nigeria.
authors.forename: Gomerep
authors.initials: G
authors.lastname: Simji
authors.affiliation: AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Nigeria; Department of Medicine, University of Jos, Nigeria.
authors.forename: Stephen
authors.initials: S
authors.lastname: Oguche
authors.affiliation: AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Nigeria; Department of Family Medicine, University of Jos, Nigeria.
authors.forename: Patricia
authors.initials: P
authors.lastname: Agaba
authors.affiliation: Department of Microbiology , University of Jos , Nigeria.
authors.forename: Patricia
authors.initials: P
authors.lastname: Lar
authors.affiliation: AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Nigeria; Department of Pediatrics, University of Jos, Nigeria.
authors.forename: Oche
authors.initials: O
authors.lastname: Agbaji
authors.affiliation: AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Nigeria; Department of Pediatrics, University of Jos, Nigeria.
authors.forename: John A
authors.initials: JA
authors.lastname: Idoko
keywords: ART naive; CD4+ cell count; HIV; sex difference; viral load