There are currently an estimated 38 million people living with HIV (PLWHIV) in the globe, and this figure is expected to rise as time goes on [1], [2]. Among this number, Africa has about 25.7 million PLWHIV [3]. The fourth-largest HIV epidemic in the world and one of the highest rates of new infections in sub-Saharan Africa are both found in Nigeria, the most populous nation in Africa. As a result of the surge in HIV treatment in Nigeria, there were approximately 903,000 people living with HIV in 18 Nigerian States as of the year 2021[4]. Life-sustaining highly active antiretroviral treatment (HAART) is administered to more than 1,679,600 individuals in this nation who are over the age of 15 [4]. Human immunodeficiency virus type 1 (HIV-1) is managed and treated with the use of the pharmaceutical regimen known as HAART. It contains a number of pharmaceuticals from the antiretroviral families [5], [6]. For several HAART drugs used to treat HIV, there are indications, mechanisms of action, and contraindications. However, long-term co-morbidities such metabolic alterations have emerged as a result of antiretroviral treatment usage [7], [8].
Numerous studies in the last five years have shown an increase in the prevalence of obesity and overweight among HIV-positive people, particularly in Africa, with a clear correlation to HAART adherence [9]–[15]. Prior research has mostly focused on evaluating how weight affects immune cells in HIV-uninfected people, with mixed results. Some findings imply that being overweight or obese is linked to greater immune cell numbers [16]–[19] while others reported that obesity results in decreased immune counts and function [20]–[23]. Since the advent of antiretroviral treatment (ART), the proportion of overweight and obese PLWHIV has grown along with the burden of metabolic disorders, particularly type 2 diabetes mellitus (T2DM), through a variety of reasons [24]–[28].
Body mass index (BMI) is calculated by dividing a person's height in meters squared by their weight in kilograms. Underweight, healthy weight, overweight, and obesity are the four weight categories that may be easily and cheaply screened using BMI. Centres for Disease Control and Prevention [29] reported the following classification by BMI values: underweight (< 18.5kg/m2); healthy weight (18.5-24.9kg/m2); overweight (25-29.9kg/m2) and obesity (30-39.9kg/m2). These cut-off values are based on statistical analysis, and it has been shown that living at the extremes of appropriate nutrition, thinness, and overweight/obesity increases the likelihood of acquiring chronic illnesses with serious negative effects on the general public health [30]–[33]. Given that obesity is linked to greater rates of infectious complications, more severe viral infections, and increased death rates owing to subpar vaccination responses, it may have a negative impact on immunological responses [34]–[39].
In the age of HAART, nothing is known about how weight affects immune cell counts in people with HIV. According to a short research, obese HIV patients had similar CD4 cell counts to normal-weight people but greater CD3, CD8, and total lymphocyte counts [40], [41], hence the need to evaluate the relationship between BMI and CD4 cell counts among people living with HIV attending Infectious Disease Hospital, Kano State. The aim of the present study was to examine the relationship between BMI and CD4 cell counts among people living with HIV attending Infectious Disease Hospital, Kano State.