Sex differences in disease severity among HIV-infected adults in Ghana

Background

There are evidence of increased rates of infection and disease progression among HIV patients in Ghana. Social and biological vulnerability have been shown to be important predictors of HIV infection, disease progression, and survival. However, it is unclear whether these differences are mediated by sex/ gender disparities in this population.

Methods

We conducted a cross-sectional survey to determine the relationship between sex, micronutrient, immune parameters and HIV progression among group of 105 women and 53 men living in Ghana. We explored relationship using chi-square and logistic regression.

Results

There were sex differences in some social determinants, women were more likely to be less educated and have low income. Women had higher CD4 counts than men did (323.9 cells/ěl versus 278.3±193.8 cells/ěl) and had lower viral load (8.2 copies/ml versus 8.7 copies/ml). They were 3 times more likely to have low viral load but progress to AIDS at the same rate as men. There were no significant sex differences in disease progression based on CD4 counts; however, nutritional analysis by stages of HIV showed that in comparison with men, women with advanced-disease CD4 count stages had a marginal deficiency of vitamin A (p=0.06).

Conclusion

Although women were more likely to have lower viral load, rate of progression did not differ in both groups. Women with the advanced staged of the HIV were also more malnourished in vitamin A. Potential implication of our study results should influence the nutritional management and eligibility of antiretroviral treatment in women.