CD4+ lymphocyte count in African patients co-infected with HIV and tuberculosis.
The objectives of this study were (a) to compare the CD4+ lymphocyte profiles over time of two groups of patients hospitalized for tuberculosis (TB) treatment [a group of patients with TB only (TB group) and a group dually infected by HIV and TB (HIV/TB group)] and (b) to assess the usefulness of the total lymphocyte count (TLC) as a surrogate of the CD4+ lymphocyte count in the HIV/TB group. A total of 345 patients were enrolled in the study of whom 104 (29.8%) were HIV seropositive (HIV/TB). On admission, the CD4+ lymphocyte counts of the HIV/TB cohort were significantly lower than the TB group with medians of 230 (interquartile range, 90-475) and 630 (500-865), respectively (p < 0.0001). The CD4+ lymphocyte count increased significantly in both cohorts on routine TB treatment. A TLC of 1,300-1,500 cells/mm3 was found to be predictive of a CD4+ lymphocyte count of < or = 200 cells/mm3 both on admission and after 1 month of TB therapy. We conclude from this study that the positive influence of TB therapy on the CD4+ lymphocyte count strongly suggests an additional avenue of influence on the course of HIV infection, whereas the usefulness of the TLC as a surrogate estimation of CD4+ lymphocyte count in HIV/TB patients has important implications for the developing world.
Martin
D J
DJ
MRC AIDS Virus Research Unit, National Institute for Virology, Sandringham, South Africa.
Sim
J G
JG
Sole
G J
GJ
Rymer
L
L
Shalekoff
S
S
van Niekerk
A B
AB
Becker
P
P
Weilbach
C N
CN
Iwanik
J
J
Keddy
K
K
D017088:AIDS-Related Opportunistic Infections / Q000208:ethnology / Q000276:immunology*; D000328:Adult; D044383:Black People; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000208:ethnology / Q000276:immunology*; D006679:HIV Seropositivity / Q000150:complications / Q000208:ethnology / Q000276:immunology; D015497:HIV-1; D006760:Hospitalization; D006801:Humans; D008297:Male; D013019:South Africa; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000208:ethnology / Q000276:immunology*