CD4+ T-LYMPHOCYTE COUNT IN HIV-INFECTED AND UNINFECTED CHILDREN IN AHMADU BELLO UNIVERSITY TEACHING HOSPITAL, ZARIA

Abstract

Studies to characterise CD4+ TLCs in HIV-infected and uninfected children have been
reported in the Caucasians and Africans. This study was undertaken to determine CD4+
TLCs in HIV-infected and uninfected children and provide preliminary data of the normal
ranges of CD4+ TLCs in HIV-uninfected children in Ahmadu Bello University Teaching
Hospital (ABUTH) Shika, Zaria, Northern Nigeria.
This hospital based cross-sectional study was conducted between April and December 2009
in children aged 24-144 months recruited from the Paediatric ARV Clinic (study subjects)
and the General Out-patient Department (controls).
A total of 122 study subjects and 122 controls not matched for age or sex were studied. The
mean age ± SD of the study subjects was 64.8 ± 35.9 months with a median of 48 months
while the controls had a mean age ± SD of 63.9 ± 36.1 months and a median of 48 months.
The mean age difference was not statistically significant (t = 0.190, df = 242, p = 0.85). The
patients were stratified into four age groups: 24-35 months, 36-59 months, 60-95 months and
96-144 months. The controls were also stratified into two age groups 24-59 and 60-144
months. The patients were further subdivided on the basis of their retroviral status into 122
controls, 49 ART naïve and 73 ART experienced. Of the 73 subjects on ART, 35 (47.9%)
were on ART for less than two years and 38 (52.1%) had been on ART for more than two
years. The duration of ART use did not impact significantly on CD4+ TLC in those on ART
(t = 0.91, p = 0.366).
There was a progressive decrease in the mean CD4+ TLC with increasing age in the study
subjects and the controls. The difference was statistically significant in all the age groups:
Controls (F = 17.22, p < 0.0001), ART experienced (F = 13.63, p = 0.001) and ART naïve (F
= 6.40, p = 0.001). The mean CD4+ TLC ± 2SD for the 24-59 months age controls was 625
2,533 cells/µl and 325-1,857 cells/µl for the 60-144 months age controls.
The mean CD4+ TLC was higher in the controls than in the study subjects in the four age
groups; 24-35 months group, the mean and standard deviation (SD) for controls was (1,721 ±
515 cells/µl), ART naïve (579 ± 309cells/µl) and ART experienced (1,358 ± 425cells/µl); 36
59 months group, the mean and SD for controls was (1,428 ± 386cells/µl), ART naïve (344 ±
220); ART experienced (1,057 ± 349cells/µl); 60-95 months group, the mean and SD for
controls was (1,158 ± 375 cells/µl), ART naïve (278 ± 172 cells/µl) and ART experienced
(743 ± 304 cells/µl); 96-144 months group, the mean and SD for controls was (976 ±
376cells/µl); ART naïve (211 ± 127 cells/µl) and ART experienced (681 ± 264 cells/µl).
These differences were statistically significant in all the age groups thus: 24-35 months (F =
39.4, p < 0.0001); 36-59 months (F = 36.1, p < 0.0001); 60-95 months (F = 35.9, p < 0.0001)
and 96-144 months (F = 18.3, p < 0.0001).
The male subjects in the ART experienced subgroup had higher median CD4+ TLCs in all
the age groups, except for the 96-144 months age group where the females recorded a higher
median CD4+ TLC (1,003 cells/µl) as against (793 cells/µl) for the males. The median CD4+
TLCs in males in the 24-35 months age group were, controls (1,735 cells/µl); ART
experienced (1,504 cells/µl); ART naïve (508 cells/ul). These differences were not
statistically significant; Controls (Z = -0.038, p = 0.970); ART experienced (Z = -0.878, p =
0.380); ART naïve (Z = -0.578, p = 0.563).
In conclusion, this study found that CD4+ TLCs decreased significantly with increasing age
in months irrespective of the retroviral status. This finding implies that CD4+ TLC could be
useful both in the diagnosis and prognosis of HIV infection in individual children. This study
also showed that HIV infection is associated with a depletion of the CD4+ TLC which
improved significantly with HAART. The study showed no statistically significant gender
differences in CD4+ TLCs.

CD4+ T-LYMPHOCYTE COUNT IN HIV-INFECTED AND UNINFECTED CHILDREN IN AHMADU BELLO UNIVERSITY TEACHING HOSPITAL, ZARIA