CD4+ and CD8+ lymphocytes and clinical features of HIV seropositive Nigerians on presentation

Eighty of 200 HIV seropositive patients admitted in the medical wards of Ahmadu Bello University Teaching Hospital, Zaria from year 1995 to 1997 were studied on presentation and compared to 40 age and sex matched controls. The main clinical features observed included weight loss, pyrexia, diarrhoea, lymphadenopathy, anaemia and pruritic dermatosis. Sixty-two of the 80 patients (73.2%) presented at stages 3 and 4 of WHO Clinical and Laboratory staging. Thirty (30) percent of these patients died between a period of one to four months after presentation. The main diseases complicating HIV infection at presentation of the 80 patients were Mycobacterium tuberculosis infection (30%), acute bacterial infections (with Salmonella typhi, Streptococcus pneumoniae and Staphylococcus aureus) (24%), candidiasis (14%) and Kaposi sarcoma (2%). Seropositivity for HIV types was found to be HIV-I alone in 43.5% of cases; HIV-II alone in 14% and both HIV-I and II in 42% of cases. Risk factors associated with HIV infection were multiple sexual partners (73%), sexually transmitted disease (70%), and unscreened blood transfusion (1%). HIV positive patients had a mean CD4+ T-cells of 0.24 x 10(9) +/- 0.17 which was significantly lower than the mean of 0.6 +/- 0. 17 x 10(9)/L for controls (P < 0.05 students t-test). Thirty (35%) of the patients had CD4+ counts of less than 0.2 x 10(9)/L (200 cells/microl) at presentation. The mean CD3+ lymphocytes count was 0.51 +/- 0.24 x 10(9)/L for patients and 1.04 +/- 0.71 x 10(9)/L for controls. The mean CD8+ lymphocyte count in patients was 0.29 +/- 0.19 x 10(9)/L and 0.44 x 10(9)/L for controls. Both CD3+ and CD8+ lymphocyte populations were statistically lower in patients than controls (P < 0.05).