scholarly journals Prediction of CD4 T-Lymphocyte Count Using WHO Clinical Staging among ART-Naïve HIV-Infected Adolescents and Adults in Northern Ethiopia: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Abraham Desta Aregay ◽  
Kibriti Mehari Kidane ◽  
Asfawosen Berhe Aregay ◽  
Kiros Ajemu Fenta ◽  
Ataklti Gebretsadik Woldegebriel ◽  
...  
Keyword(s):  
T Cell ◽  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Cd4 Count ◽  
Cd4 T Cell ◽  
Clinical Staging ◽  
Northern Ethiopia ◽  
Immunological Status ◽  
Cell Counts ◽  
Adolescents And Adults

Background. WHO clinical staging has long been used to assess the immunological status of HIV-infected patients at initiation of antiretroviral therapy and during treatment follow-up. In setups where CD4 count determination is not readily available, WHO clinical staging is a viable option. However, correlation between CD4 count and WHO clinical staging is not known in an Ethiopian setting, and hence, the main aim of this study was to assess predictability of CD4 T-lymphocyte count using WHO clinical staging among ART-naïve HIV-infected adolescents and adults in northern Ethiopia. Methods. A retrospective cross-sectional study was done in the Tigray Region, Ethiopia, from April 2015 to January 2019 from a secondary database of 19525 HIV-infected patients on antiretroviral treatment. Analysis was done using STATA-14.0 to estimate the frequencies, mean, and median of CD4 T-cell count in each WHO stages. Sensitivity, specificity, positive predictive value, negative predictive value, kappa test, and correlations were calculated to show the relationships between WHO stages and CD T-cell count. Results. The sensitivity of WHO clinical staging to predict CD4 T-cell counts of <200 cells/μl was 94.17% with a specificity of 3.62%. The PPV was 49.03%, and the NPV was 3.62%. The sensitivity of WHO clinical staging to predict CD4 T-cell counts of <350 cells/μl was 94.75% with a specificity of 3.00%. The PPV was 75.81%, and the NPV was 15.09%. Similarly, the sensitivity of WHO clinical staging to predict CD4 T-cell counts of <500 cells/μl was 95.03% with a specificity of 2.73% and the PPV and NPV were 88.32% and 6.62%, respectively. The kappa agreement of WHO clinical stages was also insignificant when compared with the disaggregated CD4 counts in different categories. The correlation of WHO clinical staging was inversely associated with the CD4 count, and the magnitude of the correlation was 5.22%. Conclusions. The WHO clinical staging had high sensitivity but low specificity in predicting patients with CD4 count <200 cells/μl, <350 cells/μl, and <500 cells/μl. There was poor correlation and agreement between CD4 T-lymphocyte count and WHO clinical staging. Therefore, WHO clinical staging alone may not provide accurate information on the immunological status of patients, and hence, it is better to use the CDC definition rather than the WHO clinical definition.

scholarly journals Determination of CD4+ T- Lymphocytes in Healthy Children of Kathmandu

2018 ◽  
Vol 16 (3) ◽  
pp. 325-329
Author(s):  
Sapana Karn ◽  
Manjula Bhattarai ◽  
Ramanuj Rauniyar ◽  
Anurag Adhikari ◽  
Pratik Karna ◽  
...  
Keyword(s):  
T Cell ◽  
Cord Blood ◽  
Cell Count ◽  
T Lymphocyte ◽  
Cd4 T Cell ◽  
Specific Reference ◽  
Healthy Children ◽  
Cross Sectional ◽  
Cell Counts ◽  
Cd4 T Cell Count

Background: The cluster differentiation (CD) of T-cell is the good marker for the immunological competence study. Nepal does not have a reference value for CD4+ T cell count and percentage for children, which severely limits the prospect of pediatric prognosis.Methods: This cross-sectional study was conducted in Kathmandu valley where total 207 children of age 0-14 year age group were recruited in this study. We analyzed 50 cord blood and 157 peripheral blood samples in order to calculate the absolute count of CD4+ T lymphocyte using Fluorescence-activated cell sorting methodology.Results: The reference range for absolute CD4+ T cell count was found to be 634-4040 cells/µL(mean1470; median: 1335 and 95% CI [1322-1617]) for male children and 491-2922 cells/µL (mean: 1443 median: 1326 and95% CI [1298-1588]) for the female children.We also observed elevated CD4 to the CD3 ratio in younger children (0.67 from cord blood Vs 0.53 from 10-14yr) compared to older ones.Conclusions: The observed CD4+ T cell counts among healthy children of Kathmandu highlights the gender differences skewed for male as well the need of defining specific reference values for other lymphocyte subsets as well in a country like Nepal which has a population with diverse genetic and socio-cultural parameters.Keywords: CD4+ T lymphocyte; children; HIV; immunophenotyping; Kathmandu; Nepal.

scholarly journals A mechanistic model for long-term immunological outcomes in South African HIV-infected children and adults receiving ART

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Eva Liliane Ujeneza ◽  
Wilfred Ndifon ◽  
Shobna Sawry ◽  
Geoffrey Fatti ◽  
Julien Riou ◽  
...  
Keyword(s):  
T Cell ◽  
Mechanistic Model ◽  
Health Sector ◽  
Cd4 Count ◽  
Cd4 T Cell ◽  
Long Term Effects ◽  
The Public ◽  
Art Initiation ◽  
Cell Counts

Long-term effects of the growing population of HIV-treated people in Southern Africa on individuals and the public health sector at large are not yet understood. This study proposes a novel ‘ratio’ model that relates CD4+ T-cell counts of HIV-infected individuals to the CD4+ count reference values from healthy populations. We use mixed-effects regression to fit the model to data from 1616 children (median age 4.3 years at ART initiation) and 14,542 adults (median age 36 years at ART initiation). We found that the scaled carrying capacity, maximum CD4+ count relative to an HIV-negative individual of similar age, and baseline scaled CD4+ counts were closer to healthy values in children than in adults. Post-ART initiation, CD4+ growth rate was inversely correlated with baseline CD4+ T-cell counts, and consequently higher in adults than children. Our results highlight the impacts of age on dynamics of the immune system of healthy and HIV-infected individuals.

scholarly journals Oral Cytokine Levels Are More Linked to Levels of Plasma and Oral HIV-1 RNA Than to CD4+ T-Cell Counts in People With HIV

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Joseph M Rocco ◽  
Zachary York ◽  
Chengli Shen ◽  
Caroline Shiboski ◽  
Jennifer Cyriaque-Webster ◽  
...  
Keyword(s):  
T Cell ◽  
Linear Regression ◽  
Opportunistic Infections ◽  
Cd4 Count ◽  
Cd4 T Cell ◽  
Plasma Viremia ◽  
Necrosis Factor Alpha ◽  
Cell Counts ◽  
Immune Mediators ◽  
Hiv 1

Abstract Background We determined the levels of 11 soluble immune mediators in oral washings of AIDS Clinical Trials Group A5254 participants with varying degrees of plasma viremia and CD4 T-cell counts to characterize the mucosal immune response at different stages of HIV-1 infection. Methods A5254 was a multicenter, cross-sectional study in people with HIV (PWH) recruited into 4 strata based on CD4 count and levels of plasma viremia: stratum (St) A: CD4 ≤200 cells/mm3, HIV-1 RNA (viral load [VL]) &gt;1000 cps/mL; St B: CD4 ≤200, VL ≤1000; St C: CD4 &gt;200, VL &gt;1000; St D: CD4 &gt;200, VL ≤1000. Oral/throat washings were obtained from all participants. Soluble markers were tested in oral/throat washings using a multibead fluorescent platform and were compared across strata. Linear regression was used to determine the associations between cytokines and HIV-1 in plasma and oral fluid. Results St A participants had higher levels of interleukin (IL)-1β, IL-6, IL-17, tumor necrosis factor alpha (TNFα), and interferon gamma (IFNγ) compared with St B and D (P = .02; P &lt; .0001) but were not different from St C. IL-8, IL-10, and IL-12 were elevated in St A compared with the other 3 strata (P = .046; P &lt; .0001). Linear regression demonstrated that oral HIV-1 levels were associated with IL-1β, IL-6, IL-8, and TNFα production (R &gt; .40; P &lt; .001) when controlling for CD4 count and opportunistic infections. Conclusions Our results show that high levels of oral HIV-1, rather than low CD4 counts, were linked to the production of oral immune mediators. Participants with AIDS and uncontrolled viremia demonstrated higher levels of pro- and anti-inflammatory soluble immune mediators compared with participants with lower HIV-1 RNA. The interplay of HIV-1 and these immune mediators could be important in the oral health of PWH.

scholarly journals Opportunistic intestinal parasites and CD4 count in HIV infected people

1970 ◽  
Vol 1 (2) ◽  
pp. 118-121 ◽  
Author(s):  
R Amatya ◽  
R Shrestha ◽  
N Poudyal ◽  
S Bhandari
Keyword(s):  
T Cell ◽  
Intestinal Parasites ◽  
Cd4 Count ◽  
Cd4 T Cell ◽  
Parasitic Infections ◽  
Cd4 Counts ◽  
Infected People ◽  
Cell Counts ◽  
Keywords Hiv ◽  
Significant Difference

Background: Opportunistic intestinal infections cause a significant morbidity and mortality among the HIV infected people. The present study was undertaken to find the prevalence of intestinal opportunistic parasitic infections among the HIV infected populace in eastern Nepal and to correlate the occurrence with the CD4 T cell counts. Materials and Methods: Stool from 122 HIV infected people were examined microscopically for the presence of parasitic ova/cyst. CD4 T cell enumeration was done using FACS Count (Becton Dickinson). Stool from 100 age matched HIV negative controls were also examined. Results: A male preponderance in the parasite positivity was seen. Twenty five of symptomatic and 2.8% of asymptomatic harboured one or more intestinal parasites.12.3% of the study population had intestinal parasitoses with 7.3% being infected with opportunistic parasites. The mean CD4 count of the subjects was 307 while those with parasitoses were 204. A statistically significant difference was seen between the CD4 counts of symptomatic and asymptomatic patients. Conclusion: Coccidian parasites are frequent opportunistic intestinal parasites infecting HIV infected patients. A lowered CD4 count predisposes to acquisition of these agents. Regular monitoring of CD4 counts and screening for these opportunistic agents in the HIV infected will help reduce the mortality and morbidity associated with infections by these agents. Keywords: HIV; Opportunistic infection; CD4 count; AIDS DOI: http://dx.doi.org/10.3126/jpn.v1i2.5405 JPN 2011; 1(2): 118-121

scholarly journals Lymphocyte subset analysis to evaluate the prognosis of HIV-negative patients with pneumocystis pneumonia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fan Jin ◽  
Jing Xie ◽  
Huan-ling Wang
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Lymphocyte Subsets ◽  
Nk Cell ◽  
Cd8 T Cell ◽  
Pneumocystis Pneumonia ◽  
Lymphocyte Subset ◽  
Cd4 T Cell ◽  
Cell Counts ◽  
Hiv Negative

Abstract Objectives We analysed the peripheral blood lymphocyte subsets of human immunodeficiency virus (HIV)-negative patients infected with pneumocystis pneumonia (PCP) to determine the relationships between the levels of different types of lymphocytes and the prognosis of patients. Methods We retrospectively reviewed HIV-negative patients with PCP diagnosed in our department. All the eligible patients underwent lymphocyte subset analysis on admission. Results A total of 88 HIV-negative PCP patients were enrolled in the study. In univariate analyses, low CD4+ T cell count, low CD8+ T cell count, and low natural killer cell (NK cell) count were associated with higher in-hospital mortality. CD8+ T cell count ≤300/μL was found to be an independent risk factor for poor prognosis in multivariate logistical regression analysis (p = 0.015, OR = 11.526, 95% CI = 1.597–83.158). Although low CD4+ T cell and NK cell counts were not independent risk factors, the mortality rates of PCP patients decreased as the CD4+ T cell and NK cell counts increased. Conclusion The immune process of Pneumocystis jirovecii infection is complex but important. We propose that lymphocyte subsets could give clinicians a better understanding of patient immune status, helping with the early identification of potentially lethal infections and treatment decision making, such as adjusting the immunosuppressive regimen and choosing an appropriate patient monitoring level.

Low absolute CD4+ T cell counts in peripheral blood predict poor prognosis in patients with newly diagnosed multiple myeloma

2020 ◽  
Vol 61 (8) ◽  
pp. 1869-1876 ◽  
Author(s):  
Yan Gu ◽  
Yuanyuan Jin ◽  
Jie Ding ◽  
Wu Yujie ◽  
Qinglin Shi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
T Cell ◽  
Peripheral Blood ◽  
Poor Prognosis ◽  
Cd4 T Cell ◽  
Newly Diagnosed ◽  
Cell Counts

scholarly journals BANA-Positive Plaque Samples Are Associated with Oral Hygiene Practices and Not CD4+ T Cell Counts in HIV-Positive Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Cathy Nisha John ◽  
Lawrence Xavier Graham Stephen ◽  
Charlene Wilma Joyce Africa
Keyword(s):  
T Cell ◽  
Periodontal Disease ◽  
Oral Hygiene ◽  
Periodontal Diseases ◽  
Cd4 T Cell ◽  
Hiv Positive ◽  
Hygiene Practices ◽  
Cell Counts ◽  
Probing Depth ◽  
Clinical Indices

Background. The “red complex” microorganisms, namely,Porphyromonas gingivalis,Treponema denticola, andTannerella forsythiaare considered as potential pathogens causing HIV-associated periodontal diseases. Moreover, it has been recognized that an association exists between CD4+ T cell counts and periodontal disease progression.Objective. To establish whether CD4+ T cell counts or oral hygiene plays a greater role in producing BANA-positive results in HIV-associated periodontal disease.Materials and Methods. One hundred and twenty HIV-positive patients participated in the study, and their CD4+ T cell counts were obtained from their medical records. The six Ramfjord teeth were used for evaluating periodontal clinical indices and subgingival plaque sampling. BANA test was used for the detection and prevalence of the “red complex” bacteria in plaque samples.Results. A majority of 69.17% HIV-positive patients were BANA-positive. No significant associations were found between BANA and CD4+ T cell counts. A highly significant association was found between BANA with probing depth and clinical attachment level (P≤0.0001) and between BANA and the use of interdental aids (P=0.0168).Conclusion. HIV-associated periodontal diseases are strongly related to oral hygiene practices rather than the effect of CD4+ T cell counts, and the use of interdental aids was marked as a significant predictor of BANA-negative plaque samples.

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