Abstract
AbstractCD4 count is an important immunological marker of disease progression in HIV seropositive patients. This study was carried out to determine the effect of malaria or fever of unknown origin on the population of CD4+ T lymphocytes of HIV seropositive patients attending the highly active antiretroviral therapy (HAART) clinic of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. 36 subjects were selected for this study. Ongoing history of fever was used as a case definition for malaria and malaria was confirmed from microscopic examination of thick and thin film of blood sample obtained from the patients during presentation with fever. The CD4 count was evaluated during presentation of fever and post-fever using flow cytometry. There was significant decrease in CD4 count of the patients. However, upon classifying the patients into 2 groups - those that returned to the clinic after a week and those that returned after a month - a significant increase in CD4 count was noticed in the group that returned after a week, while a significant decrease was noticed in the group that returned after a month (at p value of 95%). Further classification of the patients based on presence of malaria parasite, and body temperature resulted in varying effects on CD4 count post-fever (in the general group, 27 were positive for malaria parasites. Of these 27, there was an increase in CD4 count in 9 (33.3%). However in the group that returned after a week, all 6 (100%) that were positive for malaria parasites showed increase in CD4 count. Five (26.3%) of the 19 patients that had body temperature within the range of 35.5-37.4^o^C showed an increase in CD4 count, while 7 (41.2%) the 17 patients that had body temperature of 37.5^o^C and above showed an increase in CD4 count. The results led to the conclusion that while some components of the immune response to malaria could strengthen the immune system of HIV seropositive patients by increasing their CD4 count, other components will suppress their immunity by decreasing their CD4 count, accelerating the progression to AIDS.
Highlights
Human Immunodeficiency Virus (HIV) is the etiologic agent of the disease known as acquired immune deficiency syndrome (AIDS)
This work has attempted to provide answers to some controversial issues of the consequence of malaria parasite infection in HIV seropositive individuals. It is not known whether malaria accelerates the progression of HIV to full-blown AIDS or ameliorates HIV infection by feverinducing mechanism
The CD4+ T cell counts of the blood samples obtained from the 36 patients that participated in this study were evaluated during, and after episodes of malaria and fever of non-malarial origin
Summary
Human Immunodeficiency Virus (HIV) is the etiologic agent of the disease known as acquired immune deficiency syndrome (AIDS). It causes a progressive impairment of the body’s cellular immune system by destroying CD4+ T cells, leading to increased susceptibility to various infections. HIV/AIDS is a major public health problem with socio-economic burden and a serious threat to development (Bell et al, 2003). As HIV spreads, it interacts with other infectious diseases, facilitated by the increase in numbers of immunosuppressed individuals. These interactions can alter the clinical course of both diseases
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