title: CD4 lymphocyte dynamics in Tanzanian pulmonary tuberculosis patients with and without HIV co-infection.
abstract: BACKGROUND
  The interaction of HIV and tuberculosis (TB) on CD4 levels over time is complex and has been divergently reported.
  
  
  METHODS
  CD4 counts were assessed from time of diagnosis till the end of TB treatment in a cohort of pulmonary TB patients with and without HIV co-infection and compared with cross-sectional data on age- and sex-matched non-TB controls from the same area.
  
  
  RESULTS
  Of 1,605 study participants, 1,250 were PTB patients and 355 were non-TB controls. At baseline, HIV was associated with 246 (95% CI: 203; 279) cells per μL lower CD4 counts. All PTB patients had 100 cells per μL lower CD4 counts than the healthy controls. The CD4 levels were largely unchanged during a five-month of TB treatment. HIV infected patients not receiving ART at any time and those already on ART at baseline had no increase in CD4 counts after 5 months of TB treatment, whereas those prescribed ART between baseline and 2 months, and between 2 and 5 months increased by 69 (22;117) and 110 (52; 168) CD4 cells per μL after 5 months.
  
  
  CONCLUSIONS
  The increase in circulating CD4 levels observed in PTB in patients is acquired after 2 months of treatment irrespective of HIV status. Initiation of ART is the strongest factor correlated with CD4 increase during TB treatment.
  
  
  BACKGROUND
  Clinical trials.gov: NCT00311298.
authors.affiliation: Department of Infectious Diseases, Odense University Hospital, University of Southern Denmark, Odense C, Denmark. aase.bengaard.andersen@ouh.regionsyddanmark.dk
authors.forename: Aase B
authors.initials: AB
authors.lastname: Andersen
authors.forename: Nyagosya S
authors.initials: NS
authors.lastname: Range
authors.forename: John
authors.initials: J
authors.lastname: Changalucha
authors.forename: George
authors.initials: G
authors.lastname: Praygod
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Kidola
authors.forename: Daniel
authors.initials: D
authors.lastname: Faurholt-Jepsen
authors.forename: Henrik
authors.initials: H
authors.lastname: Krarup
authors.forename: Harleen M S
authors.initials: HM
authors.lastname: Grewal
authors.forename: Henrik
authors.initials: H
authors.lastname: Friis
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D016022:Case-Control Studies; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013636:Tanzania / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents