Abstract
CD4 cell count (CD4 count) is pivotal in determining when to initiate antiretroviral therapy and in staging of human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS). It gives information on possible treatment failure. This study was undertaken to evaluate the CD4 count of treatment naive HIV–positive patients who registered at HIV clinic of Anambra State University Teaching Hospital Awka, Anambra State. 460 case notes of all confirmed, HIV-positive patients who enrolled at the HIV clinic of Anambra State University Teaching Hospital Awka between Jan 2011-June 2013 were retrieved from the medical records. Baseline CD4 count, sex, age, ethnicity, occupation and religion were recorded and reviewed.143 patients (31.09%) were males, while 317 (68.91%) were females with male to female ratio being 1:2.2. 39.13% were between 21-30 age range, closely followed by 31-40 age range with 33.48%. Only one patient (0.22%) belonged to above 70 age group. The occupation of most patients was business/trade which had 165 patients (35.87%). 22.61% were self-employed. The least was professional with 15 patients (3.26%). Those with CD4 count of less than 350 cells/mm 3 were 240 (52.17%) while 220 (47.83%) had above 350 cells/mm 3 . 119 patients (25.9%) had CD4 count of 200 cells/mm 3 or less. Based on current guidelines, most HIV positive patients in this study
Highlights
CD4 refers to a glycoprotein found on the surface of immune cells such as T helper cells, monocytes, macrophages and dendritic cells
5.44% were in the 20 & less age range. 39.13% belonged to 21-30 age range. 33.48% were in the 31-40 age range. 15.65% were in the 41-50 age range. 5.0% were in the 51-60 age range. 61-70 age range had five patients (1.08%)
Those who had between 401-600 cells/mm3 were 96 in number (20.87%). 9.35% had between 601-800 cells/mm3. lastly, 39 patients (8.46%) had CD4 count of above 800 cells/mm3
Summary
CD4 (cluster of differentiation 4) refers to a glycoprotein found on the surface of immune cells such as T helper cells, monocytes, macrophages and dendritic cells. Helper T cells which help in the functions of the immune system. CD4 count, measures the degree of immunosuppression in HIV-positive patients. The reference standards used to monitor HIV infection are flow cytometric analysis of T lymphocyte subsets to provide the CD4 T cell count and molecular assays to quantify plasma HIV load. Few laboratories in resource- constrained countries can afford to perform these tests (Crowe et al, 2003). In Nigeria, CD4 count is routinely done It plays an important role in deciding when to commence therapy, staging the disease, monitoring disease progression and determining treatment failure. CD4 count takes priority over viral load if both tests cannot be carried out together because of financial constraints (Crowe et al, 2003). It is increasingly becoming more affordable to patients in developing countries (Mellors et al, 1997; Lutwana et al, 2008)
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