Can serum concentration of C-reactive protein, albumin and body weight serve as an index of disease progression and treatment assessment in HIV/AIDS subjects?

Abstract

Background: Human immunodeficiency virus infection induces an acute phase response which is marked by changes in the plasma concentrations of acute phase proteins and a fall in CD4+T-cell counts and body weight.
Objective: To determine whether serum concentration of C-reactive protein, serum albumin level and body weight can serve as an index of disease progression and treatment assessment in HIV/AIDS. Methodology: The study investigated 80 subjects (40 subjects on anti-retroviral therapy and 40 not on therapy) and 40 sero-negative subjects (control) attending the HIV/AIDS Clinic in Nnamdi Azikiwe Teaching Hospital, Nnewi, Nigeria. We determined serum concentrations of C-reactive protein, serum albumin levels and body weights. The C-reactive protein was estimated using semi-quantitative method, albumin level was estimated using bromocresol green method, and biuret method was used for total protein. The CD4+T-cell count of the subjects was determined using CyFlow Analyzer while their weights were measured using high precision weighing balance.
Results: We observed that the mean weight (Kg), CD4+T-cells count (count/mm3), serum albumin (g/L), and total protein (g/L) of HIV subjects on therapy and those not on therapy were significantly lower (p<0.05) than in the control subjects. The mean C-reactive protein (mg/dL) was significantly higher in subjects on therapy compared to those not on therapies and the control subjects, p<0.05.
Conclusion: In resource-poor regions or remote areas or villages where CD4+T-cell counts and viral load tests may not be available, the concentration of C-reactive protein, serum albumin level and changes in weight may serve as a reliable alternative marker for disease progression and treatment assessment for HIV subjects.

Keywords: Acute-phase proteins, anti-retroviral therapy, total protein