ASSESSMENT OF DIAGNOSTIC TECHNIQUES FOR HUMAN IMMUNE DEFICIENCY VIRUS HIV

CHAPTER ONE INTRODUCTION Globally, the burden of HIV/AIDS has grown rapidly. The World Health Organization (WHO, 1997) reported an exponential rise in global HIV prevalence, with an estimated 4.1 million new infections expected in 2003 alone. In Africa, the first cases were reported in 1982. Nigeria recorded its first documented cases in 1986, primarily among sex workers in Lagos and Calabar. Despite intensified awareness and prevention campaigns, infection rates have continued to rise, affecting millions, particularly among the economically active population. The situation in Nigeria remains alarming. Reports from tertiary hospitals, including UNTH, indicate a persistent increase in HIV incidence. The economic and demographic impact is substantial, particularly as the infection disproportionately affects the working population. As a result, HIV/AIDS should be considered a public health emergency, requiring strategic, diagnostic, and policy-level responses. In the scientific domain, significant advances have been made. For instance, Dr. Robert Gallo's research team succeeded in isolating a virus from AIDS patients, later named HTLV-III due to its similarity with other human T-lymphotropic viruses (Neser, 2001). Further studies revealed that asymptomatic individuals could carry and transmit the virus, emphasizing the importance of accurate and early diagnostic procedures (Peiperls, 1995). 1.2 STATEMENT OF THE PROBLEM The primary challenge facing HIV/AIDS management in developing countries is the inability to establish and prioritize realistic research and control strategies. Despite decades of awareness and funding, diagnostic infrastructures remain inadequate, contributing to delayed detection and increased transmission. Clinical diagnosis alone is insufficient due to the virus's capacity for asymptomatic latency. Many individuals remain undiagnosed until their immune systems are severely compromised. This underlines the need for precise laboratory-based techniques capable of identifying infections at early stages. Several diagnostic methods have been employed, including ELISA, Western Blot, and Radioimmunoassay. However, disparities in accessibility, cost, sensitivity, and specificity create inconsistency in HIV testing outcomes. Therefore, it is critical to assess these tools comparatively to identify the most efficient and sustainable option for routine diagnostic practice. 1.3 AIMS AND OBJECTIVES To evaluate current diagnostic techniques for Human Immunodeficiency Virus (HIV). To recommend the most accurate, accessible, and cost-effective method for HIV diagnosis based on reliability and performance. 1.4 HYPOTHESIS Null Hypothesis (H₀): There is no significant difference in the diagnostic outcomes of Western Blot, ELISA, and Radioimmunoassay among HIV-infected individuals. Alternative Hypothesis (H₁): There is a significant difference in the diagnostic outcomes of Western Blot, ELISA, and Radioimmunoassay among HIV-infected individuals. 1.5 SIGNIFICANCE OF THE STUDY The importance of accurate and timely diagnosis in the control of HIV cannot be overstated. Early detection facilitates prompt initiation of antiretroviral therapy (ART), which is essential for reducing viral load, improving patient prognosis, and minimizing the risk of transmission. By comparing key diagnostic methods, this study aims to inform clinical decisions and improve the overall quality of HIV care, especially in resource-constrained healthcare settings like those found in many parts of Nigeria. From a public health perspective, the study contributes to evidence-based policymaking by identifying cost-effective and widely applicable diagnostic strategies. Since ELISA, Western Blot, and RIA vary significantly in terms of availability, cost, and technical complexity, the findings can help guide national HIV testing protocols, donor-funded programs, and non-governmental health initiatives targeting vulnerable populations. The results can also assist policymakers in allocating limited resources efficiently to maximize diagnostic coverage and impact. Furthermore, the research adds to the existing body of knowledge by offering comparative insight into traditional and modern diagnostic technologies. It serves as a reference for future academic inquiries, medical training curricula, and laboratory management practices. By recommending the most reliable and accessible testing technique, the study ultimately supports the national and global agenda of ending the HIV/AIDS epidemic through informed, evidence-driven diagnostic practices. 1.6 SCOPE OF THE STUDY This study focuses on evaluating the effectiveness of three major diagnostic techniques—Enzyme-Linked Immunosorbent Assay (ELISA), Western Blot, and Radioimmunoassay (RIA)—in detecting HIV infections. It was carried out using clinical samples collected from patients at the University of Nigeria Teaching Hospital (UNTH), Enugu. The study examines the diagnostic accuracy, sensitivity, specificity, accessibility, and cost-efficiency of these methods. While it emphasizes laboratory-based diagnostics, it does not extend into the clinical management or therapeutic interventions for HIV-positive individuals. The research is limited to adult patients and does not include pediatric or antenatal populations. 1.7 LIMITATIONS OF THE STUDY This study was conducted at the University of Nigeria Teaching Hospital (UNTH), Enugu. Key limitations included financial constraints, which restricted the scope of data collection and access to advanced diagnostic reagents. Additionally, time constraints imposed by academic deadlines limited the duration and comprehensiveness of the study, affecting its ability to include a larger sample size or a broader regional representation.