title: Correlation of CD4 counts with the FNAC patterns of tubercular lymphadenitis in patients with HIV: a cross sectional pilot study.
abstract: BACKGROUND
  Fine needle aspiration cytology (FNAC) of TB lymphadenitis (TBL) in HIV shows four different patterns, which may be reflective of immune status. We hypothesize that the CD(4) counts, a marker of immunologic status, correlates with FNAC morphology of TBL. This study was undertaken to compare the mean CD(4) counts across the different cytology patterns and to correlate the CD(4) counts with FNAC patterns in these patients.
  
  
  METHODS
  Forty newly diagnosed HIV patients with TBL on FNAC (10 in each pattern) were selected by convenient sampling based on inclusion exclusion criteria. The CD(4) counts were obtained in these patients. Its correlation with different FNAC patterns was assessed using SPSS version 16.
  
  
  RESULTS
  Analysis of covariance showed significant difference in the mean CD(4) counts between all the four patterns [F (374), df (3), P-value = 0.000]. Spearman's correlation analysis showed significant correlation of CD(4) counts with the FNAC patterns (correlation coefficient of 0.967; P-value of 0.01) with pattern 1 having low CD(4) counts and pattern 4 having high CD(4) counts.
  
  
  CONCLUSIONS
  CD(4) counts show significant correlation with FNAC patterns of TBL in HIV patients. Pattern 1, suggestive of poor immunological response (chiefly necrosis, occasional ill defined granuloma, AFB 3+) had low CD(4) counts, while pattern 4, suggestive of good immunological response (well defined granuloma, no necrosis and AFB 1+), had high CD(4) counts. Thus FNAC patterns may be used to predict the CD(4) counts in HIV patients where CD(4) facilities are not available or vice versa.
authors.affiliation: Department of Pathology and Department of Biochemistry, St. John's Medical College and Hospital, Koramangala, Bangalore, Karnataka, India.
authors.forename: Joseph Sushil
authors.initials: JS
authors.lastname: Rao
authors.forename: Jaya
authors.initials: J
authors.lastname: Kumari S
authors.forename: Usha
authors.initials: U
authors.lastname: Kini
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D014388:Tuberculosis, Lymph Node / Q000473:pathology*
keywords: CD4 counts; FNAC; HIV; tuberculous lymphadenitis