Height-weight indices in HIV-infected children

Abstract

Background: CD4 and CD8 T cells facilitate the containment of tuberculosis (TB) and has been postulated that there will be changes in their level in patients with TB. So this study was carried out to analyse the CD4 cell counts in pulmonary tuberculosis (PTB) patients with reference to their HIV status and determine the relation between the severity of PTB and CD4 count. Methods & Materials: A cross-sectional study was conducted at the CD4 laboratory, Department of Microbiology fromMay 2012 to April 2013 and was approved by IERB, BPKIHS. A total of 160 individuals, 40 each in the PTB, PTB/HIV, HIV and healthy population was included after obtaining informed consent. PTB diagnosis was made according to national tuberculosis program guidelines. HIV test was done following the VCT guidelines of Nepal. CD4 T cells were analyzed using a BD FACS Count Cytometer. Data were entered in Microsoft Excel 2007 and analyzed using SPSS version 11.7. Results: The mean absolute CD4 cells in PTB patient was 562.20±197.3 cells/ul, which was a clear reduction (p<0.001) when compared to the healthy population of this area (786.30±239.17cells/ul). Therewas significantdecrease in theCD4 level among theHIV/TBpatient (123.70±99.4 cells/ul) as compared to PTB patient without HIV(p<0.001). The study also noted that the mean CD4 cell level among HIV infected population (249.68 cells/ul)was higher compared to theHIV/TB co-infectedpopulation (p<0.05). No correlation between bacillary load and CD4 cells was observed in PTB patient, although a decreasing CD4 cellswere associated with increasing bacillary load in HIV/TB co-infected patient. Conclusion: CD4 cell count can reflect the degree of immunosuppression in PTB patient irrespective of their HIV status but it cannot predict the disease severity in PTB patient.