Comparing the level of CD4 T lymphocytes, to pulmonary features of tuberculosis in HIV patients in a local hospital

Abstract

Aim: This study is to assess the effect of CD4 T lymphocytes, on features of pulmonary tuberculosis on HIV positive patients with co-existing tuberculosis attending clinic in university of Benin Teaching Hospital Benin Nigeria.

Setting: University of Benin Teaching Hospital Benin, Nigeria.

Method: This study was carried out on 200 patients who had laboratory confirmation of HIV, CD4 T lymphocytes measured, with tuberculosis co-infection, and control group of 100 patients, who were HIV negative, but positive for tuberculosis infection, between 1st July, 2003 and 30th May, 2004, were further examined with chest radiography, in the hospital. The standard procedures of chest radiography were used, with minor adjustment to allow good image quality on the radiograph. Two Radiologists analyzed these on standard image viewing box.

Results: The average CD4 T lymphocyte count in the study group (HIV sero-positive) was 173.90 cells/nl and median of 172 cells/nl. 128 (64%) subjects had CD4 T lymphocyte counts less than 200 cell/nl while 72(36%) subjects had CD, lymphocyte count above or equal to 200 cells/nl. 111 (86.72%) subjects with a CD4 T lymphocyte count less than 200 cells/nl and 31 (43.1%) subjects with CD4 T lymphocyte count 200cells/nl or more had an atypical chest radiographic pattern of primary pulmonary tuberculosis. Atypical chest radiogra phic pattern was more frequent among patients with CD4 T lymphocyte count less than 200 cell/nl (86.72%) compared with patients with CD4 T lymphocyte count greaterthan 200 cells/nl (43.1%) (P < 0.001).

Conclusion: There is significant relationship and correlation between immune status of HIV positive patient and pulmonary pattern of tuberculosis. The variation on pulmonary pattern of tuberculosis noted also collaborated well with the level of CD4 T lymphocyte in the patients.