Cellular Immunity and Immune Activation Markers in HIV Seropositive Tuberculosis Patients in Zaria, Nigeria

Abstract

Background: The CD4+ T lymphocyte is used in disease staging in both HIV and Tuberculosis/HIV co infection. Its cost and technical requirements have necessitated search for alternative tests. The search for a cheaper surrogate for the CD4+ T lymphocytes count is imperative in resource limited settings dependent on donor funding as ours necessitated this study. Materials and method: The study subjects were new patients who presented to Ahmadu Bello University Teaching Hospital (ABUTH) Zaria during the study period. They underwent clinical evaluation, relevant investigations. Those found to be co infected with TB/HIV further had CD4+ T lymphocytes count, beta-2-microglobulin (β2M) and Erythrocyte Sedimentation Rates (ESR) evaluated and were consecutively included in the study. HIV negative tuberculosis patients and normal persons served as controls. Findings: Seventy five study subjects were included in the study. Their mean CD4+ count was 178 ± 116.81 cells/ul., serum beta-β2M level was 3.29mg/L, tuberculin skin test (TST) reaction was 5 ±6.7mm and erythrocyte sedimentation rate (ESR) was 67.88 ± 37.32mm/hr, which were statistically significantly different from the TB only and controls. Conclusion and recommendation: The ESR and the TST reaction had weak and moderate predictive values for CD4+ count respectively. The association is too weak for these to be recommended as surrogates for CD4+ T lymphocytes count and progression in HIV/TB co infected patients.