CD4 lymphocyte dynamics in Tanzanian pulmonary tuberculosis patients with and without hiv co-infection

BMC Infectious Diseases

Henrik Friis³  Harleen MS Grewal⁴  Henrik Krarup¹  Daniel Faurholt-Jepsen³  Jeremiah Kidola²  George PrayGod²  John Changalucha²  Nyagosya S Range⁵  Aase B Andersen⁶ 

[1]Department of Clinical Biochemistry, Aalborg University Hospital, 9000 Aalborg, Denmark

[2]National Institute for Medical Research, Mwanza Medical Research Centre, Mwanza, Tanzania

[3]Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, 1958 Frederiksberg C, Denmark

[4]The Gade Institute, Section for Microbiology and Immunology, University of Bergen and Haukeland University hospital, N- 5016 Bergen, Norway

[5]National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania

[6]Department of Infectious Diseases, Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, DK 5000 Odense C, Denmark

关键词: TB treatment;    CD4 cells;    HIV;    Pulmonary tuberculosis;   

Others  :  1175424
DOI  :  10.1186/1471-2334-12-66

 received in 2011-11-06, accepted in 2012-03-21,  发布年份 2012

【 摘 要 】

Background

The interaction of HIV and tuberculosis (TB) on CD4 levels over time is complex and has been divergently reported.

Methods

CD4 counts were assessed from time of diagnosis till the end of TB treatment in a cohort of pulmonary TB patients with and without HIV co-infection and compared with cross-sectional data on age- and sex-matched non-TB controls from the same area.

Results

Of 1,605 study participants, 1,250 were PTB patients and 355 were non-TB controls. At baseline, HIV was associated with 246 (95% CI: 203; 279) cells per μL lower CD4 counts. All PTB patients had 100 cells per μL lower CD4 counts than the healthy controls. The CD4 levels were largely unchanged during a five-month of TB treatment. HIV infected patients not receiving ART at any time and those already on ART at baseline had no increase in CD4 counts after 5 months of TB treatment, whereas those prescribed ART between baseline and 2 months, and between 2 and 5 months increased by 69 (22;117) and 110 (52; 168) CD4 cells per μL after 5 months.

Conclusions

The increase in circulating CD4 levels observed in PTB in patients is acquired after 2 months of treatment irrespective of HIV status. Initiation of ART is the strongest factor correlated with CD4 increase during TB treatment.

Trial registration number

Clinical trials.gov: NCT00311298

【 授权许可】

   
2012 Andersen et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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