Role of Serum Albumin Level Compared to CD4+ Count as a Marker of Immunosuppression in HIV/AIDS Patients

BACKGROUND AND OBJECTIVES: AIDS is one of the most devastating infectious Diseases in human history, and the causative agent HIV. The most common cause of HIV disease throughout the world, is HIV-1, which comprises several subtypes. The disease progression in HIV is defined on the basis of clinical features. CD4+ counts and HIV RNA levels are prognostic indicators of HIV disease progression but in developing countries their use is limited due to cost andtechnology constraints. Recent studies have suggested that low levels of serum albumin are associated with rapid disease progression and AIDS associated mortality.This study aims at establishing role of serum albumin level as a surrogate marker in HIV / AIDS patients as compared to CD4+ counts. OBJECTIVES: 1. To evaluate serum albumin level in patients with HIV/AIDS patients. 2. To correlate between serum albumin levels and CD4+ cell count as a marker of immunosuppression in HIV/AIDS patients. METHODS: This prospective follow up case control study included 194HIV/AIDS patients presenting to GOVERNMENT STANLEY MEDICAL COLLEGE during the period of March 2018 to March 2019 and controls were age and sex matched normal people.Descriptive and Analytical Statistics were done to find correlation of albumin with CD4+ T lymphocyte count in HIV/AIDS patients. RESULTS: 40.5% cases were between 31-40 years of age and 70% were males.47.9% of the patients were diagnosed recently in last three months and fever (40%)was most common presenting complaint. Most common opportunist was pulmonary tuberculosis (52.1%) Albumin showed a direct correlation with CD4 count both at baseline (p<0.001) and during follow up (p<0.001) in cases .Such correlation was absent in the controls both at baseline and follow up. Regression analysis showed linear trend between albumin and CD4 count(p=0.01) CONCLUSION: There was a strong correlation between CD4+ count and albumin in cases both at baseline and follow up. Regression analysis showed significant linear trend indicating that albumin could be used as a surrogate marker for immunosuppression in HIV/AIDS patients.