Low absolute CD4 counts in Ethiopians

The CD4+ T-lymphocyte count is a widely used marker of HIV disease progression. The marker also plays a crucial role in determining therapeutic interventions in HIV infections, especially with the initiation and monitoring of antiretroviral therapy and prophylactic treatment for opportunistic infections. In general, immunological studies done thus far on adult Ethiopians revealed that, healthy HIV-negative Ethiopians exhibit significantly decreased values for absolute CD4 counts than other populations. However, it remains to be illucidated whether Ethiopian AIDS patients develop opportunistic infections at much lower CD4 values than AIDS patients from Western countries, and whether Ethiopian HIV infected patients progress to AIDS more rapidly. Thus, establishing locally appropriate standard CD4 values is important in order to implement certain prophylactic or therapeutic interventions in our setting. Most of these studies are reported on international journals, which are hardly accessible to the Ethiopian medical/scientific community. The aim of this mini-review is, therefore, to provide the local scientific community and clinicians with the available information.