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Immunohaematological reference values in Human Immunodeficiency Virus-negative adolescent and adults in rural northern Tanzania

By Rebecca Weintraub, MD | 16 Jan, 2009

Background
The amount of CD4 T cells is used for monitoring HIV progression and improvement, and to make decisions to start antiretroviral therapy and prophylactic drugs for opportunistic infections. The aim of this study was to determine normal reference values for CD4 T cells, lymphocytes, leucocytes and haemoglobin level in healthy, HIV negative adolescents and adults in rural northern Tanzania.

Methods
A cross sectional study was conducted from September 2006 to March 2007 in rural northern Tanzania. Participants were recruited from voluntary HIV counselling and testing clinics. Patients were counselled for HIV test and those who consented were tested for HIV. Clinical screening was done, and blood samples were collected for CD4 T cell counts and complete blood cell counts.

Results
We enrolled 102 participants, forty two (41.2%) males and 60 (58.8%) females. The mean age was 32.6 + 95% CI 30.2-35.0. The mean absolute CD4 T cell count was 745.8 + 95% CI 695.5-796.3, absolute CD8 T cells 504.6 + 95% CI 461.7-547.5, absolute leukocyte count 5.1 + 95% CI 4.8-5.4, absolute lymphocyte count 1.8 + 95% CI 1.7-1.9, and haemoglobin level 13.2 + 95% CI 12.7-13.7. Females had significantly higher mean absolute CD4 T cell count (p=0.008), mean absolute CD8 T cell count (p=0.009) and significantly lower mean haemoglobin level than males (p=0.003)

Conclusion
Immunohaematological values found in this study were different from standard values for western countries. Females had significantly higher mean CD4 T cell counts and lower mean haemoglobin levels than males. This raises the issue of the appropriateness of the present reference values and guidelines for monitoring HIV/AIDS patients in Tanzania.

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    Summary: Background
    The amount of CD4 T cells is used for monitoring HIV progression and improvement, and to make decisions to start antiretroviral therapy and prophylactic drugs for opportunistic infections. The aim of this study was to determine normal reference values for CD4 T cells, lymphocytes, leucocytes and haemoglobin level in healthy, HIV negative adolescents and adults in rural northern Tanzania.

    Methods
    A cross sectional study was conducted from September 2006 to March 2007 in rural northern Tanzania. Participants were recruited from voluntary HIV counselling and testing clinics. Patients were counselled for HIV test and those who consented were tested for HIV. Clinical screening was done, and blood samples were collected for CD4 T cell counts and complete blood cell counts.

    Results
    We enrolled 102 participants, forty two (41.2%) males and 60 (58.8%) females. The mean age was 32.6 + 95% CI 30.2-35.0. The mean absolute CD4 T cell count was 745.8 + 95% CI 695.5-796.3, absolute CD8 T cells 504.6 + 95% CI 461.7-547.5, absolute leukocyte count 5.1 + 95% CI 4.8-5.4, absolute lymphocyte count 1.8 + 95% CI 1.7-1.9, and haemoglobin level 13.2 + 95% CI 12.7-13.7. Females had significantly higher mean absolute CD4 T cell count (p=0.008), mean absolute CD8 T cell count (p=0.009) and significantly lower mean haemoglobin level than males (p=0.003)

    Conclusion
    Immunohaematological values found in this study were different from standard values for western countries. Females had significantly higher mean CD4 T cell counts and lower mean haemoglobin levels than males. This raises the issue of the appropriateness of the present reference values and guidelines for monitoring HIV/AIDS patients in Tanzania.

    Source: BMC Infectious Diseases

    Publication Date: January 13, 2008

    Language: English

    Keywords: Immunohaematological reference values, Monitoring & Measurement, Publications & Research, Tanzania

 

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