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Volume 6, Issue 2 (Suppl) Virol-mycol
ISSN: 2161-0517 VMID, an open access journal Virology Asia 2017
May 11-12, 2017
May 11-12, 2017 Singapore
10th World Congress on
Virology and Mycology
Immunological and virological discordance in patients on antiretroviral therapy: Still a grey area in HIV
research
Ganesh Shanmugasundaram Anusuya
Sree Balaji Medical College and Hospital, India
Statement of the Problem: Effective ART generally results in immune reconstitution with increased CD4 and virologic suppression
with undetectable HIV viral load (VL). However a major concern regarding ART is when there is a discordant response between CD4
count and the viral load. There are two types of discordant responses: Immunological failure (decrease in CD4 count) despite VL
suppression or immune reconstitution (increase in CD4 count) despite VL failure. Interestingly both types of discordant responses to
ART are related to AIDS defining events and mortality.
Discussion: The discordant response to ART is still a grey area in HIV research. Several studies done around the world have shown
the prevalence of discordance ranging from 8% to more than 20%. Several causes attributed for discordant response were Zidovudine
based regimen, protease inhibitors, older age, younger median age, lower baseline CD4 count, associated opportunistic infections and
baseline viral loads. The wide differences in prevalence of discordance can be attributed to several factors including different criteria
for immunological response, virologic suppression, sample size, variation in time to failure, ethnic background and importantly
different types of ART regimens. We also recommend the global HIV related authorities to implement uniform guidelines for
immunological and virological response, so that the wide difference attributed to the prevalence of discordance can be assessed
and decided whether it is a true difference in prevalence. These discordant groups need to be carefully monitored for opportunistic
infections and more studies are needed as to ways to improve the immunologic response in these patients and also to find out the
exact cause of discordance. Further studies like exploring the genetic sequencing of this discordant group is required.
Biography
Ganesh ShanmugasundaramAnusuya has been working in the field of HIV/AIDS since 2006 in India. He has worked as Tamil Nadu State AIDS Control (TANSACS)
STI Medical Officer, ART Medical Officer and HIV Community Care Centre Medical Officer. After Undergraduation, he completed his fellowship in HIV Medicine
from Government Hospital of Thoracic Medicine (GHTM), Tambaram, which is a Centre of Excellence for HIV treatment, care and support in India. He has been
selected as best outgoing fellow and worked as Chief Fellow in International Training and Education Centre for Health, India. Subsequently, he completed his MD
in Community Medicine from Sree Balaji Medical College and Hospital (SBMCH), Bharath University, Chennai. He was the first person as Principal Investigator to
study about discordant response to ART in patients enrolled in a Government programme in India. He has done international presentations of his research work in
Africa, UK, India, France, and in USA with many publications. He has been nominated by GHTM and SBMCH for the SAARC Prize on HIV/AIDS 2016 pertaining
to his contributions in HIV research. His areas of research interest are discordant response to ART, virology, Quality of Life, clinical immunology and public health.
Currently he is involved in HIV research, undergraduate & postgraduate teaching, in-charge of free medical camp activities, guiding PhD candidates, conducting
conferences, CME, and Public health awareness programmes in SBMCH as an Assistant Professor in Community Medicine department.
Ganesh Shanmugasundaram Anusuya, Virol-mycol 2017, 6:2 (Suppl)