Association between blood group, CD4, Viral load and opportunistic infections among patients attending Kericho county referral comprehensive care clinic, Kenya

Abstract

Erythrocyte antigens bringing about blood groups are considered pathogen receptor sites, including Human Immunodeficiency Virus (HIV), affecting approximately 39.9 million people worldwide, with 3.31% and 3.3% prevalence in Kenya and Kericho County, respectively. Limited studies showing inconsistent results and unpublished perceptions suggest a possible role of blood groups in Human Immunodeficiency Virus disease surveilled by changes in CD4 counts, viral load and opportunistic infections among infected. This study determined the ABO-Rhesus blood group distribution and association with CD4 counts, viral load and opportunistic infections at the Kericho County Referral Hospital Comprehensive Care Clinic in the year 2020. This cross-sectional, retrospective study comprised randomly sampled adults (≥18 years) without bone marrow transplant or transfusion history, with the sample size (n=285) calculated using the Yamane Taro formula. ABO-Rhesus typing was done on venous ethylenediaminetetraacetic acid blood using commercial antisera. Viral load and CD4 counts, determined using Abbott m2000sp/rt and FacsCalibur, respectively, and opportunistic infection data were documented in the data extraction form. Statistical Package for Social Sciences SPSS® version 26 was used to analyse and summarise data as means, standard deviation and prevalence ratios. Z-test, analysis of variance, regression, and chi-square were used to contrast, compare means, assess outcomes among variables, and determine relationships, respectively. Ethical principles were observed during specimens’ and participants’ information handling. Females were the majority, 174 (61.1%), and the mean age was 42.8 (12.8) years. Blood group O was most prevalent at 138 (48.4%), followed by A at 78 (27.4%), B at 59 (20.7%), and the least was AB. The Analysis of Variance showed a statistically non-significant association between blood groups on both viral load (p=0.74) and CD4 counts (p=0.84). Predictors for viral load change on regression analysis found increased viral load improvement in blood group AB-positive compared to blood group A-positive (OR=6.77, 95% CI [1.82-14.33], p=0.01). Most of the participants did not develop opportunistic infections, n=209 (73.3%). Tuberculosis was more prevalent among blood groups on chi-square: A-positive (16.2%), B-positive (16.4%), O-positive (17.7%), O-negative (12.5%) and B-negative. Blood groups A-negative and AB-negative developed no opportunistic infections. The differences were, however, not significant at the 95% level of significance (p=0.91). The study showed a non-significant association between the ABO blood groups and HIV infection based on CD4 counts, viral load and opportunistic infections. However, group AB-positive and those with good adherence were associated with viral load improvement. Increased CD4 count and body mass index were associated with reduced opportunistic infections. Viral load increase was associated with likelihood of opportunistic infection. Further studies need to be conducted for comparison.