CD4+ T-lymphocytopenia in severe pulmonary tuberculosis without evidence of human immunodeficiency virus infection.
METHODS
A large public hospital in Buenos Aires, Argentina.


OBJECTIVE
To determine the number of blood CD4 and CD8 T-lymphocytes in male human immunodeficiency virus (HIV) negative patients with severe pulmonary tuberculosis.


METHODS
Seventeen patients with severe pulmonary tuberculosis (SPT), with a mean age of 44.1 years, all HIV negative, had on admission lost 20% or more of their normal weight. Ten male HIV negative pulmonary tuberculosis patients (PT), with a mean age of 25.2 years, in good general condition, acted as a control group. Patients from both groups had a blood CD4/CD8 count before treatment.


RESULTS
In the SPT patients, the CD4/CD8 count before treatment yielded a mean of 341.25 +/- 142.73/ mm3 for CD4 and 259.33 +/- 100.89/mm3 for CD8. Three patients died a few weeks after starting treatment; on admission they had 180,220 and 280 CD4/ mm3, respectively. Patients in good general condition yielded 721.40 +/- 272.20 for CD4 (P < 0.01, t = 4.216) and 416.67 for CD8. At the same time, five normal volunteers, with a mean age of 35.60 +/- 10.45 years, had mean CD4 and CD8 counts of 906 +/- 75.37 and 360 +/- 190.79, respectively.


CONCLUSIONS
Based on the findings of this study, we feel that it is of value to measure the CD4 and CD8 T-lymphocyte counts in STP patients with a compromised general condition and with significant weight loss at the beginning of treatment. Those patients with a CD4 count of < 300/mm3 have a very poor prognosis and, in addition to the regular antituberculosis drugs, will require intensive care during the first weeks of treatment.
Pilheu
J A
JA
Phthisiopulmonology Division, Dr. Enrique Tornu Hospital, Buenos Aires, Argentina.
De Salvo
M C
MC
Gonzalez
J
J
Rey
D
D
Elias
M C
MC
Ruppi
M C
MC
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D018023:HIV Seronegativity; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012016:Reference Values; D012680:Sensitivity and Specificity; D018344:T-Lymphocytopenia, Idiopathic CD4-Positive / Q000175:diagnosis / Q000209:etiology*; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy
D000995:Antitubercular Agents