The Effect of Acute Severe Illness on CD4+ Lymphocyte Counts in Nonimmunocompromised Patients

Aldrich, Jenifer; Gross, Robert; Adler, Mary; King, Kathy; MacGregor, Rob Roy; Gluckman, Stephen J.

doi:10.1001/archinte.160.5.715

Cited by 29 publications

(19 citation statements)

References 6 publications

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“…Reduced immunosuppression is known to occur in many disease states, including HIV infection [7,8]. In HIV infection, disease activity and progression highly correlate with low CD4 cells count [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Factors of Low CD4 Cells Count in Treatment-naïve HIV Subjects in Southeast Nigeria

Anyabolu¹

2017

J AIDS Clin Res

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Background and objectives: Human immunodeficiency virus (HIV) infection is a global healthcare problem. Low CD4 cells count, an index of immunosuppression, is associated with escalating activity and progression of HIV infection. The factors which influence low CD4 cells count have not been completely identified nor are they evaluated in routine clinical practice. The aim of this study was to determine the prevalence of low CD4 cells count and to evaluate the factors which might influence immunosuppression in treatment-naïve HIV subjects in Southeast Nigeria.Methodology: This was a cross-sectional study involving treatment-naïve HIV subjects. Anthropometric and demographic data were obtained and CD4 cells count and other relevant investigations performed. The data were compared between those who have low CD4 cells count, defined, here, as CD4 <200 cells/ml, and those with CD4 ≥ 200 cells/ml. Potential risk factors of low CD4 cells count were determined. Results:The mean age of the subjects was 39+11 years. Females were made up 283 (72.0%) and males 110 (28.0%). The median value of the CD4 cells count was 391. Low CD4 cells count was prevalent in 49 (12.5%) of the subjects. There was significant association between CD4 cells count and body mass index (df=2, p=0.017), as well as serum low density lipoprotein cholesterol (df=1, p=0.027) and anemia (df=3, p=0.025). Significant, but poor, correlation was observed between CD4 cells count and 24 h urine protein (r=-0.117, p=0.023), creatinine clearance (r=-0.122, p=0.018), as well as hemoglobin (r=0.224, p<0.001). Creatinine clearance was a predictor of low CD4 cells count, p=0.001. Conclusion:The prevalence of low CD4 cells count was high in this study. Abnormal weight, dyslipidemia and proteinuric renal damage were common among treatment-naïve subjects who have low CD4 cells count. referrals from the neighboring states. Owerri, where the hospital situates, has a local municipal population of about 125,337, whereas the state population is conservatively put at 3,927,563 [18].The criteria for inclusion in this study were age range of 16-65 years and treatment-naïve HIV-positive status. Pregnancy, adrenal disease, renal or terminal illness and malignancy were the exclusion criteria. From each of the study subjects, informed written consent was obtained. The Ethics Committee of the hospital gave approval for the study.From each of the subjects anthropometric and demographic data were obtained with the aid of a questionnaire administered by our laboratory technicians who explained to them the aim of the study. The place of domicile and origin, gender and age of the subjects were obtained. Weight and height were taken and BMI rendered as weight/ height 2 (kg/m 2 ). Blood pressure was measured [19].Clear instructions were given to all the subjects on how to collect 24 h urine sample. For each subject, a day-time random spot urine sample and blood samples were collected at the end of the 24 h urine sample collection [19][20][21].From the random spot urine samples coll...

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Section: Introductionmentioning

confidence: 99%

“…These include demographic and genetic factors, low body mass index (BMI), commercial sex workers, and behavioral factors, all in HIV-negative individuals [8,[14][15][16][17]. In HIV-infected individuals, it has been demonstrated that low CD4 cells count is a predictor of AIDS syndrome and disease progression.…”

Section: Introductionmentioning

confidence: 99%

Factors of Low CD4 Cells Count in Treatment-naïve HIV Subjects in Southeast Nigeria

Anyabolu¹

2017

J AIDS Clin Res

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“…Another limitation of our study is that acute illnesses can cause CD4 lymphopenia 19,20 and total lymphopenia 21 in patients not infected with HIV. This finding has led to the accepted practice of not evaluating CD4 cell count during an acute phase of illness.…”

Section: Discussionmentioning

confidence: 96%

Evaluation of the Centers for Disease Control and Prevention's Recommendations Regarding Routine Testing for Human Immunodeficiency Virus by an Inpatient Service: Who Are We Missing?

Greenwald

Rich

Bessega

et al. 2006

Mayo Clinic Proceedings

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“…3,4 However, there are numerous reports of ICL associated with different diseases and clinical conditions. [5][6][7] Opportunistic infections, mostly seen in HIV patients, are the most common among them. [8][9][10][11][12][13][14][15][16][17][18][19][20][21] Although CD4CT-lymphocytopenia could be found among otherwise immunocompetent patients admitted to our ICU, it was never so profound and protracted as it was in ICL.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Cd4+T-lymphocytopenia—two unusual patients with cryptococcal meningitis

Lepur

Vranjican

Baršić

et al. 2005

Journal of Infection

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The Effect of Acute Severe Illness on CD4+ Lymphocyte Counts in Nonimmunocompromised Patients

Cited by 29 publications

References 6 publications

Factors of Low CD4 Cells Count in Treatment-naïve HIV Subjects in Southeast Nigeria

Factors of Low CD4 Cells Count in Treatment-naïve HIV Subjects in Southeast Nigeria

Evaluation of the Centers for Disease Control and Prevention's Recommendations Regarding Routine Testing for Human Immunodeficiency Virus by an Inpatient Service: Who Are We Missing?

Idiopathic Cd4+T-lymphocytopenia—two unusual patients with cryptococcal meningitis

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