CD4 lymphocyte dynamics in Tanzanian pulmonary tuberculosis patients with and without hiv co-infection
1 Department of Infectious Diseases, Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, DK 5000 Odense C, Denmark
2 National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania
3 National Institute for Medical Research, Mwanza Medical Research Centre, Mwanza, Tanzania
4 Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, 1958 Frederiksberg C, Denmark
5 Department of Clinical Biochemistry, Aalborg University Hospital, 9000 Aalborg, Denmark
6 The Gade Institute, Section for Microbiology and Immunology, University of Bergen and Haukeland University hospital, N- 5016 Bergen, Norway
BMC Infectious Diseases 2012, 12:66 doi:10.1186/1471-2334-12-66Published: 21 March 2012
The interaction of HIV and tuberculosis (TB) on CD4 levels over time is complex and has been divergently reported.
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.
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.
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.
Trial registration number
Clinical trials.gov: NCT00311298