CD4-T-Lymphocyte Reference Ranges in Uganda and Its Influencing Factors

Nanzigu, Sarah; Waako, Paul; Petzold, Max; Kiwanuka, Gertrude N.; Dungu, Henry; Makumbi, Fred; Gustafsson, Lars L.; Eriksen, Jaran

doi:10.1309/lmft0vce1ugo9ygd

Cited by 12 publications

(24 citation statements)

References 28 publications

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“…However, the values of CD4 + T lymphocytes mean, median, and 95% normal reference interval were lower than from the study done in Kenya [ 20 ], Uganda (mean: 938, reference interval: 418–2105 cells/ μ L) [ 8 ], Central Africa Republic study done by Menard et al (mean: 940, median: 912, reference interval: 386–1454 cells/ μ L) [ 17 ], healthy Nigerian adults done (mean: 847, reference interval: 365–1571 cells/ μ L) [ 11 ]; this was again maybe by different geographical location.…”

Section: Discussionmentioning

confidence: 75%

“…CD4 + T lymphocyte cells coordinate the immune system's response to the pathogens [ 4 ], and hence, normal reference interval values are critically important for the correct interpretation of diagnostic tests [ 5 ]. The influence of geographical location, racial and ethnic background, age, sex, and conditions of living on the distribution of human peripheral blood T lymphocyte subpopulations has already been documented in various studies of a given population in different parts of the world [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Establishment of Normal Reference Intervals for CD3⁺, CD4⁺, CD8⁺, and CD4⁺to CD8⁺Ratio of T Lymphocytes in HIV Negative Adults from University of Gondar Hospital, North West Ethiopia

Gize

Mathewos

Moges

et al. 2014

AIDS Research and Treatment

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Background. Reference values for the CD3+, CD4+, CD8+, and CD4+ to CD8+ ratio T lymphocyte subsets are adopted from textbooks. But for appropriate diagnosis, treatment, and follow-up of patients, correct interpretations of the laboratory results from normal reference interval are mandatory. This study was, therefore, planned to establish normal reference interval for T lymphocytes subset count and CD4+ to CD8+ ratio. Methods. A cross-sectional study was conducted on apparently healthy adult individuals who visited voluntary counseling and HIV testing clinic Gondar University Hospital from April to May, 2013. Whole blood was analyzed using fluorescence-activated cell sorting (BD FACS, San Jose, CA) machine to enumerate the T-cell subpopulations. Results. Out of the total 320 study participants, 161 (50.3%) were men and 159 (49.7%) were women. The normal reference intervals were (655–2,823 cells/μL), (321–1,389 cells/μL), and (220–1,664 cells/μL) for CD3+, CD4+, and CD8+ T lymphocyte subsets, respectively, and CD4+ to CD8+ ratio was 0.5–2.5. Conclusion. The overall CD3+ T lymphocytes reference interval in the current study was wide; low CD4+ T lymphocytes, CD4 to CD8 ratio, and high CD8+ T lymphocytes values were observed.

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Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Establishment of Normal Reference Intervals for CD3⁺, CD4⁺, CD8⁺, and CD4⁺to CD8⁺Ratio of T Lymphocytes in HIV Negative Adults from University of Gondar Hospital, North West Ethiopia

Gize

Mathewos

Moges

et al. 2014

AIDS Research and Treatment

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“…The JCRC is more experienced at HIV/ART management given the time period the center has been providing treatment, and we would have expected better outcomes at this site. However, we earlier described how geographic demographics affect CD4 T-lymphocyte cell counts when we reported healthy volunteers from Mbarara having lower mean CD4 cells compared to the Kampala population 34. In that previous report, we expressed that individuals with previously high-normal CD4 values may present with falsely high-enough CD4 values in comparison to the national cutoff points for treatment initiation, and we recommended an integration of the knowledge of patients’ socioeconomic and health histories in populations with wide CD4 reference ranges.…”

Section: Discussionmentioning

confidence: 92%

Poor immunological recovery among severely immunosuppressed antiretroviral therapy-naïve Ugandans

Nanzigu¹,

Kiguba²,

Kabanda³

et al. 2013

HIV

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IntroductionCD4 T lymphocytes remain the surrogate measure for monitoring HIV progress in resource-limited settings. The absolute CD4 cell counts form the basis for antiretroviral therapy (ART) initiation and monitoring among HIV-infected adults. However, the rate of CD4 cell change differs among patients, and the factors responsible are inadequately documented.ObjectiveThis study investigated the relationship between HIV severity and ART outcomes among ART-naïve Ugandans, with the primary outcome of complete immunological recovery among patients of different baseline CD4 counts.MethodsPatients’ records at two HIV/ART sites – the Joint Clinic Research Centre (JCRC) in the Kampala region and Mbarara Hospital in Western Uganda – were reviewed. Records of 426 patients – 68.3% female and 63.2% from JCRC – who initiated ART between 2002 and 2007 were included. HIV severity was based on baseline CD4 cell counts, with low counts considered as severe immunosuppression, while attaining 418 CD4 cells/μL signified complete immunological recovery. Incidence rates of complete immunological recovery were calculated for, and compared between baseline CD4 cell categories: <50 with ≥50, <100 with ≥100, <200 with ≥200, and ≥200 with ≥250 cells/μL.ResultsThe incidence of complete immunological recovery was 158 during 791.9 person-years of observation, and patients with baseline CD4 ≥ 200 cells/μL reached the end point of immunological recovery 1.89 times faster than the patients with baseline CD4 < 200 cells/μL. CD4 cell change also differed by time, sex, and site, with a faster increase observed during the first year of treatment. CD4 cell increase was faster among females, and among patients from Mbarara.ConclusionInitiating ART at an advanced HIV stage was the main reason for poor immunological recovery among Ugandans. Earlier ART initiation might lead to better immunological responses.

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“…The mean is also similar to the works of Chama et al ., (751.41 cells/μl) in Maiduguri, Nigeria,24 Dayama et al ., (764 ± 249 cells/μl) in India,35 Eno-Tanjoung et al ., in Cameroun33 (851 ± 254 cells/μl).…”

Section: Discussionmentioning

confidence: 99%

Cluster of differentiation 4+ cell count mean value, reference range and its influencing factors in Human Immunodeficiency Virus-seronegative pregnant women in Lagos

et al. 2014

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Background:Immunity in pregnancy is physiologically compromised and this may affect cluster of differentiation four (CD4) count levels. It is well established that several factors affect CD4 count level in pregnancy. This study aims to determine the effects of maternal age, gestational age, parity and level of education as they influence CD4 count in pregnancy and also to determine the mean and reference range of CD4 count in pregnancy in Lagos, Nigeria.Materials and Methods:A descriptive cross-sectional study was carried out at Ante-natal clinics in Lagos State, Nigeria. About 5 mls of blood was collected into Ethylene Diamine Tetracetic Acid (EDTA) bottles from HIV-negative pregnant women in various gestational ages of pregnancy. CD4+ cell count and full blood count of all samples were done within 3 hours of collection. The descriptive data was given as means ± standard deviation (SD). Pearson's chi-squared test and correlation were used for analytical assessment.Results:A total of 74 pregnant women were recruited. The age range was 19–41 years and a mean age of 30.42 ± 5.34 years. The CD4+ cell count was not statistically significant when compared with participants ages P = 0.417, neither with gestational ages P = 0.323, nor with parity P = 0.247 nor level of education P = 0.96. An overall mean CD4+ cell count was 771.96 ± 250 cells/μl and the range was 193–1370 cells/μl.Conclusion:Maternal age, gestational age, parity and level of education had no significant effects on CD4+ cell count levels in pregnancy. The mean CD4+ cell count of HIV-negative pregnant women in Lagos is 771.96 ± 250 cells/μl.

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CD4-T-Lymphocyte Reference Ranges in Uganda and Its Influencing Factors

Cited by 12 publications

References 28 publications

Establishment of Normal Reference Intervals for CD3⁺, CD4⁺, CD8⁺, and CD4⁺to CD8⁺Ratio of T Lymphocytes in HIV Negative Adults from University of Gondar Hospital, North West Ethiopia

Establishment of Normal Reference Intervals for CD3⁺, CD4⁺, CD8⁺, and CD4⁺to CD8⁺Ratio of T Lymphocytes in HIV Negative Adults from University of Gondar Hospital, North West Ethiopia

Poor immunological recovery among severely immunosuppressed antiretroviral therapy-naïve Ugandans

Cluster of differentiation 4+ cell count mean value, reference range and its influencing factors in Human Immunodeficiency Virus-seronegative pregnant women in Lagos

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CD4-T-Lymphocyte Reference Ranges in Uganda and Its Influencing Factors

Cited by 12 publications

References 28 publications

Establishment of Normal Reference Intervals for CD3+, CD4+, CD8+, and CD4+to CD8+Ratio of T Lymphocytes in HIV Negative Adults from University of Gondar Hospital, North West Ethiopia

Establishment of Normal Reference Intervals for CD3+, CD4+, CD8+, and CD4+to CD8+Ratio of T Lymphocytes in HIV Negative Adults from University of Gondar Hospital, North West Ethiopia

Poor immunological recovery among severely immunosuppressed antiretroviral therapy-na&iuml;ve Ugandans

Cluster of differentiation 4+ cell count mean value, reference range and its influencing factors in Human Immunodeficiency Virus-seronegative pregnant women in Lagos

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Establishment of Normal Reference Intervals for CD3⁺, CD4⁺, CD8⁺, and CD4⁺to CD8⁺Ratio of T Lymphocytes in HIV Negative Adults from University of Gondar Hospital, North West Ethiopia

Establishment of Normal Reference Intervals for CD3⁺, CD4⁺, CD8⁺, and CD4⁺to CD8⁺Ratio of T Lymphocytes in HIV Negative Adults from University of Gondar Hospital, North West Ethiopia

Poor immunological recovery among severely immunosuppressed antiretroviral therapy-naïve Ugandans