Serum Calcium and Follicle-stimulating Hormone Levels in ART-Naïve versus ART-experienced HIV Patients at Rivers State University Teaching Hospital in Nigeria

Abstract

Aim: to evaluate serum calcium and FSH levels in ART-naïve HIV patients and those on ART attending the HIV clinic at Rivers State University Teaching Hospital, Port Harcourt. Study Design: Analytical cross-sectional study. Place and Duration of Study: Rivers State University Teaching Hospital in Port Harcourt, Nigeria., between September and November 2025. Methodology: An analytical cross-sectional design was employed, involving 60 participants (30 ART-naïve and 30 on ART for ≥6 months). Participants who met the following criteria were recruited: adults aged 18–60 years, confirmed HIV-positive status through rapid diagnostic test and confirmatory ELISA, were willing to give informed consent to participate in the study and belonged to either of the two groups: naïve or on ART ≥ 6 months. The sample size for this study was calculated using Cochran formula for cross sectional studies. Five mL of blood was collected from each of the participants and serum calcium was measured using the O-cresolphthalein complexone method, and FSH was assessed via fluorescence immunoassay method. Data were analyzed using SPSS version 25, with independent t-tests and chi-square tests applied and results were considered statistically significant at 95% confidence interval (p<0.05). Results: Results showed significantly lower mean serum calcium in ART subjects compared to ART-naïve subjects (p=0.001), suggesting ART-related bone metabolism disruption. Mean FSH levels were significantly higher in ART patients than in ART-naïve patients (p=0.001), indicating potential pituitary or gonadal dysfunction. Conclusion: These findings highlight the need for routine monitoring of calcium and reproductive hormones in HIV patients on ART to mitigate complications like osteoporosis and infertility. Recommendations include integrating calcium and FSH testing into Nigeria’s HIV treatment guidelines and promoting dietary interventions to improve patient outcomes.