Acta Scientific Microbiology (ISSN: 2581-3226)

Research Article Volume 5 Issue 2

The Correlation of Tuberculosis Smear Results and Immuno-suppression with CD4+ Counts as Surrogate Among HIV Infected Patients

Kingsley Kamvuma*, Yusuf ademola, Warren Chanda, Michelo Miyoba, Sam Bezza Phiri, Christopher Newton Phiri and John Amos Mulemena

Mulungushi University, School of Medicine and Health Sciences, Zambia

*Corresponding Author: Kingsley Kamvuma, Mulungushi University, School of Medicine and Health Sciences, Zambia.

Received: October 07, 2021; Published: January 10, 2022

Abstract

Background: Human immunodeficiency virus (HIV) and M. tuberculosis are two intracellular pathogens that interact at the cellular, clinical and population levels. Since the recognition of AIDS in 1981, the number of reported cases of TB in the world has increased substantially, especially in regions with high incidence of AIDS. The main aim of this study was to establish whether there is a relationship between sputum smear positives and low CD4 cell counts among HIV infected patients.

Materials and Methods: This was a retrospective study involving 473 participants. The patients recruited in this study were those who tested HIV positive and smear positive for TB. Their HIV status was determined by performing an HIV blood test, if they were HIV positive their CD4 cell count were then made.

Results: This study examined the relation between smear positivity and low CD4 (below 200 cells/µl) together with CD8 and CD3 markers as a measure of immune function among patients infected with HIV. The study participants’ constituted males 67% and females 33%. The overall mean age was 33.2 (SD 6.9) with the youngest and oldest participants being 18 and 60 respectively. It was found that smear positive results negatively (r = -0.13; p = 0.021) correlated with CD4+ below 200 cells/µl. No correlation was observed between smear positives and CD8+ or CD3+ since the calculated correlation coefficient was not statistically 0.007 (p = 0.9) and 0.03 (p = 0.6) respectively. There were more 3+ smear results below 200 cells/µl than the others while above 200 cells/µl 1+ was the most commonly reported smear result. The scanty smear positives were the least commonly reported result in the low and high CD4 counts.

Conclusion: The smear positive result negatively correlated with a low CD4+ (r = -0.13; p = 0.021) but no correlation with low CD+8 and CD+3 results was observed. The long held theory that low bacillary counts in patients with low CD4+ counts needs to be revisited. The reduction of CD4+ cell count parallels' that of the total lymphocyte count and is more marked in patients with high bacillary counts. Further, studies are required to confirm these findings

Keywords: TB; HIV; CD4; Smear; Patients

References

  1. K C Bloch., et al. “Incidence and clinical implications of isolation of Mycobacterium kansasii: results of a 5-year, population-based study”. Annals of Internal Medicine9 (1998): 698-704.
  2. N Caccamo., et al. “Multifunctional CD4 (+) T cells correlate with active Mycobacterium tuberculosis infection”. European Journal of Immunology8 (2010): 2211-2220.
  3. G J Pontororing., et al. “The burden and treatment of HIV in tuberculosis patients in Papua Province, Indonesia: a prospective observational study”. BMC Infectious Diseases1 (2010): 362.
  4. Sarder Nasir Uddin., et al. “Consequence on Treatment of TB Patients Affected by HIV/AIDS A Conceptual Research”. American Journal of Infectious Diseases 4 (2006): 210-218.
  5. C K Kwan and J D Ernst. “HIV and Tuberculosis: a Deadly Human Syndemic”. Clinical Microbiology Reviews 2 (2011): 351-376.
  6. B E Jones., et al. “CD4 Cell Counts in Human Immunodeficiency Virus—Negative Patients with Tuberculosis”. Clinical Infectious Diseases5 (1997): 988-991.
  7. A Jaryal., et al. “Manifestations of tuberculosis in HIV/AIDS patients and its relationship with CD4 count”. Lung India4 (2011): 263-266.
  8. Ministry of Health. “2009 Annual Health Statistical Bulletin”. Ministry of Health Zambia (2011).
  9. “Home” (2022).
  10. Z Toossi., et al. “Impact of tuberculosis (TB) on HIV-1 activity in dually infected patients”. Clinical and Experimental Immunology 2 (2009): 233-238.
  11. S S Abdool Karim., et al. “HIV infection and tuberculosis in South Africa: an urgent need to escalate the public health response”. Lancet9693 (2009): 921-933.
  12. R L Smith., et al. “Factors affecting the yield of acid-fast sputum smears in patients with HIV and tuberculosis”. Chest3 (1994): 684-686.
  13. J S Sutherland., et al. “Polyfunctional CD4 (+) and CD8 (+) T cell responses to tuberculosis antigens in HIV-1-infected patients before and after anti-retroviral treatment”. Journal of Immunology11 (2010): 6537-6544.
  14. G Sussman and A A Wadee. “Production of a suppressor factor by CD8+ lymphocytes activated by mycobacterial components”. Infection and Immunity 8 (1991): 2828-2835.
  15. AM Elliott., et al. “The impact of HIV on infectiousness of pulmonary tuberculosis: a community study in Zambia”. AIDS7 (1993): 981-987.

Citation

Citation: Kingsley Kamvuma., et al. “The Correlation of Tuberculosis Smear Results and Immuno-suppression with CD4+ Counts as Surrogate Among HIV Infected Patients". Acta Scientific Microbiology 5.2 (2022): 02-09.

Copyright

Copyright: © 2022 Kingsley Kamvuma., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days

Indexed In






News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2022.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US