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Free Content CD4+ T-lymphocytopenia in severe pulmonary tuberculosis without evidence of human immunodeficiency virus infection

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Abstract:

SETTING: A large public hospital in Buenos Aires, Argentina.

OBJECTIVE: To determine the number of blood CD4 and CD8 T-lymphocytes in male human immunodeficiency virus (HIV) negative patients with severe pulmonary tuberculosis.

DESIGN: Seventeen patients with severe pulmonary tuberculosis (SPT), with a mean age of 44.1 years, all HIV negative, had on admission lost 20% or more of their normal weight. Ten male HIV negative pulmonary tuberculosis patients (PT), with a mean age of 25.2 years, in good general condition, acted as a control group. Patients from both groups had a blood CD4/CD8 count before treatment.

RESULTS: In the SPT patients, the CD4/CD8 count before treatment yielded a mean of 341.25 ± 142.73/mm3 for CD4 and 259.33 ± 100.89/mm3 for CD8. Three patients died a few weeks after starting treatment; on admission they had 180, 220 and 280 CD4/mm3, respectively. Patients in good general condition yielded 721.40 ± 272.20 for CD4 (P < 0.01, t = 4.216) and 416.67 for CD8. At the same time, five normal volunteers, with a mean age of 35.60 ± 10.45 years, had mean CD4 and CD8 counts of 906 ± 75.37 and 360 ± 190.79, respectively.

CONCLUSION: Based on the findings of this study, we feel that it is of value to measure the CD4 and CD8 T-lymphocyte counts in STP patients with a compromised general condition and with significant weight loss at the beginning of treatment. Those patients with a CD4 count of < 300/mm3 have a very poor prognosis and, in addition to the regular antituberculosis drugs, will require intensive care during the first weeks of treatment.

Keywords: CD4/CD8; T-lymphocytopenia; severe tuberculosis

Document Type: Regular Paper

Affiliations: Phthisiopulmonology Division, “Dr. Enrique Tornu” Hospital, Buenos Aires, Argentina

Publication date: 1997-10-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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