title: Predictors of CD4+ lymphocyte count among HIV-seropositive and HIV-seronegative pregnant women in Dar es Salaam, Tanzania.
abstract: OBJECTIVE
  To determine the predictors of CD4+ lymphocyte count among pregnant women in Dar es Salaam, Tanzania.
  
  
  METHODS
  Between 04/1995 and 03/1997, HIV-seropositive (n=1,027) and HIV-seronegative (n=280) pregnant women were interviewed to obtain socio-demographic characteristics. Later, blood samples was collected for determination of T-lymphocyte subsets and other haematological indices.
  
  
  RESULTS
  CD4+ lymphocyte count was significantly higher among HIV-seronegative women (mean=770 cells/mm3, standard deviation (SD)=232 cells/mm3) than HIV-seropositive women (mean=422 cells/mm3, SD=205 cells/mm3). Most HIV-seropositive women were asymptomatic, in WHO clinical stage 1 (84.3%). Among HIV-seropositive women, total white blood count (WBC) and erythrocyte sedimentation rate (ESR) remained significantly correlated with CD4+ after adjusting for other predictors in multivariate analyses. For women of average age 25 years, the CD4+ lymphocyte count increased by about 16 cells/mm3 for each increment of 1000 WBC cells/mm3, while each 10 mm/hr increase in ESR was associated with a reduction of CD4+ lymphocyte count of about 8 cells/mm3.
  
  
  CONCLUSIONS
  These results show that simple and inexpensive haematological indices cannot be recommended for use as alternative measures of HIV-related immunosuppression in this population of mainly asymptomatic women.
authors.affiliation: Department of Epidemiology and Biostatistics, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
authors.forename: S H
authors.initials: SH
authors.lastname: Kapiga
authors.forename: D
authors.initials: D
authors.lastname: Mwakagile
authors.forename: D
authors.initials: D
authors.lastname: Spiegelman
authors.forename: G I
authors.initials: GI
authors.lastname: Msamanga
authors.forename: D
authors.initials: D
authors.lastname: Hunter
authors.forename: W W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000276:immunology; D018023:HIV Seronegativity / Q000276:immunology*; D006679:HIV Seropositivity / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D011247:Pregnancy / Q000276:immunology*; D011251:Pregnancy Complications, Infectious / Q000276:immunology; D013636:Tanzania