Percentage and Absolute CD4+ Count and Factors Influencing Their Levels in Tuberculosis Patients in a Tetiary Hospital, Kaduna, Nigeria

Madaki Suzie, Yusuf Mohammed
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Abstract

Background: The role of CD4+ T cells in immunity against tuberculosis have been widely acknowledged. This study determined CD4+ absolute, CD4 percentage and haemoglobin (HB) levels in tuberculosis (TB) patients undergoing TB treatment and compared these levels with presence of some factors which could modify the quantities of CD4+, CD4% and HB in TB patients. Methods: A cross-sectional study of eighty-five persons attending TB DOTS clinic in tertiary hospital between 2020 to 2021. Multicolour fluorescence imaging and absorbance spectrometry microscopy was used to enumerate CD4+ absolute count, CD4+ percentage and HB concentration in whole blood. Questionnaire and interviews were used to determine history, demographic data, BCG vaccination, BCG scar, vitamin A supplementation, awareness of zoonotic diseases and zoonotic TB, maternal BCG vaccination status, maternal BCG scar and undernutrition for each respondent. Results: CD4% significantly differed between forty-seven males (mean age: 33.5) and thirty-eight females (mean age: 32.2) (p <0.05). T-test indicated no significant difference in CD4+ count, CD4% and HB compared with BCG vaccination status, presence of BCG scar, knowledge of zoonotic diseases, knowledge of zoonotic TB and with vitamin A supplementation (p <0.05). There was also significant difference in CD4% compared with undernutrition and in absolute CD4+ counts compared with drug resistance (p <0.05). Conversely, there was significant difference in CD4% and absolute CD4+ count when compared with maternal BCG vaccination, presence of maternal BCG Scar. Pearson correlation coefficient indicated weak negative relationship between CD4%, absolute CD4+ count and age. Also, weak positive relationship between HB and age. Both relationships were not significant (p <0.05). Conclusion: Undernutrition, gender, maternal BCG vaccination (with or without scaring) and age influence levels of CD4+ in TB patients.
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尼日利亚卡杜纳一家三级医院肺结核患者CD4+百分比和绝对计数及其影响因素
背景:CD4+ T细胞在结核病免疫中的作用已被广泛认识。本研究测定了接受结核治疗的结核患者CD4+绝对值、CD4百分比和血红蛋白(HB)水平,并将这些水平与一些可能改变结核患者CD4+、CD4%和HB数量的因素进行了比较。方法:对2020 - 2021年在三级医院结核病DOTS门诊就诊的85例患者进行横断面研究。采用多色荧光成像和吸收光谱显微镜计数全血CD4+绝对计数、CD4+百分比和HB浓度。采用问卷调查和访谈的方式确定每位调查对象的病史、人口统计资料、卡介苗接种情况、卡介苗疤痕、维生素A补充情况、对人畜共患疾病和人畜共患结核的认识、母体卡介苗接种情况、母体卡介苗疤痕和营养不良情况。结果:47名男性(平均年龄:33.5岁)与38名女性(平均年龄:32.2岁)的CD4%差异有统计学意义(p <0.05)。t检验显示,CD4+计数、CD4%和HB与卡介苗接种情况、卡介苗疤痕存在情况、人畜共患疾病知识、人畜共患结核病知识以及补充维生素A组比较无显著差异(p <0.05)。CD4%与营养不良组比较,CD4+绝对计数与耐药组比较,差异均有统计学意义(p <0.05)。相反,与母体接种卡介苗、存在卡介苗瘢痕相比,CD4%和绝对CD4+计数有显著差异。Pearson相关系数显示CD4%、CD4+绝对计数与年龄呈弱负相关。HB与年龄呈弱正相关。两种关系均不显著(p <0.05)。结论:营养不良、性别、母亲接种卡介苗(有无瘢痕)和年龄影响结核病患者CD4+水平。
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