CD4+ T-lymphocytopenia in severe pulmonary tuberculosis without evidence of human immunodeficiency virus infection
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.
Document Type: Regular Paper
Affiliations: Phthisiopulmonology Division, “Dr. Enrique Tornu” Hospital, Buenos Aires, Argentina
Publication date: 1997-10-01
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