Volume : VII, Issue : V, May - 2017

Comparison of CD4+ T lymphocyte counts in HIV negative patients of pulmonary tuberculosis and tuberculous meningitis

Chawla S, Kakkar R

Abstract :

 Background The co–relation between HIV and CD4+ T lymphocyte counts has been extensively studied over the past 3 decades.  The significance of CD4+ lymphopenia in other diseases has been studied less exhaustively. We have evaluated the CD4+ counts and nutritional status in patients of pulmonary and extra pulmonary tuberculosis, in the absence of HIV infection. Methods Patients diagnosed with pulmonary and extra pulmonary TB ( tuberculous meningitis ) were recruited from the in–patient wards over a 1 year period at a tertiary centre in Dehradun. PTB was diagnosed on the basis of sputum smear positivity for AFB, and TBM was diagnosed on clinical grounds, and/ or CSF examination and response to ATT. After excluding HIV infection in all patients, CD4+ counts were measured using flow cytometry.  The counts and the nutritional status of the 2 groups of patients were then compared using chi square analysis with the help of SPSS 23.0. Results In total, 82 patients were recruited, 50 patients suffering from PTB and 32 suffering from TBM. There was a male dominance with majority patients below the age of 30 years in both groups of patients. The mean CD4+ counts in the PTB group were 541.54 cells/mm3 with 34% of the patients having subnormal counts. The mean CD4+ counts in the TBM group were 481.75 cells/ mm3 with 53.12% of the patients having subnormal counts. The mean BMI in the 2 groups was 22.95kg/m2  and 21.85 kg/ m2 .., with 12% patients underweight in the PTB group and 25% underweight in the TBM group. Increase in BMI was associated with higher CD4+ counts in both sets of patients. Conclusions A high proportion of tuberculosis patients had subnormal counts despite the absence of HIV infection. The mean CD4+ counts were significantly lower in the TBM group as compared to the PTB group, though both groups had counts significantly lower than the normal population. Lower BMI was associated with lower CD4+ counts, which progressively increased with increase in BMI. The improvement in CD4+ count, if any, to ATT could however not be assessed by this study.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Chawla S, Kakkar R, Comparison of CD4+ T lymphocyte counts in HIV negative patients of pulmonary tuberculosis and tuberculous meningitis, INDIAN JOURNAL OF APPLIED RESEARCH : Volume‾7 | Issue‾5 | May‾2017

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