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Factors associated with CD4 lymphocyte counts in HIV-negative Senegalese individuals
1Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
Insights
This study in Senegal found that while CD4 counts vary, men generally have lower counts than women. Smoking was also linked to higher CD4+ lymphocyte levels in HIV-negative adults.
Area of Science:
- Immunology
- Public Health
- Epidemiology
Background:
- CD4+ lymphocytes are crucial for immune function and a key indicator in HIV/AIDS progression.
- CD4 counts naturally fluctuate due to various factors, impacting their interpretation in HIV-negative individuals.
- Understanding baseline CD4 levels and influencing factors is vital for accurate clinical assessment, especially in regions with high infectious disease burdens like Senegal.
Purpose of the Study:
- To establish reference CD4+ lymphocyte counts in an HIV-uninfected adult population in Senegal.
- To identify demographic, behavioral, and clinical factors influencing CD4 and CD3 lymphocyte counts in this population.
- To provide baseline data for interpreting CD4 counts in HIV-negative individuals in Senegal.
Main Methods:
- Cross-sectional study involving 681 HIV-uninfected adults in Senegal.
- Inclusion of diverse groups: commercial sex workers, symptomatic outpatients, and family planning service users.
- Analysis of CD4 and CD3 lymphocyte counts using multivariable regression, adjusting for age, gender, smoking, and other factors.
Main Results:
- Significant differences in CD4 and CD3 counts were observed among the four study groups.
- Commercial sex workers exhibited the highest mean CD4 counts (966.0 cells/microl), while men had the lowest (711.6 cells/microl).
- After adjustment, gender and smoking independently influenced CD4 counts: men had lower counts (beta = -156.4) and smokers had higher counts (beta = 124.0).
Conclusions:
- This study provides the first baseline CD4+ lymphocyte reference levels for HIV-negative adults in Senegal.
- Gender and smoking are significant independent factors influencing CD4 counts in this population.
- Findings can assist clinicians in better interpreting CD4 counts for HIV-negative individuals in Senegal, aiding in disease management and diagnosis.
Abstract:
CD4+ lymphocytes are a primary target of the human immunodeficiency virus (HIV), and CD4 counts are one of the factors used to measure disease progression in HIV-positive individuals. CD4 counts vary in uninfected individuals and across populations due to a variety of demographic, environmental, immunological and genetic factors that probably persist throughout the course of HIV infection. This study sought to determine reference levels and identify factors that influence lymphocyte counts in 681 HIV-uninfected adults in Senegal, where residents are exposed to a variety of infectious diseases and other conditions that may affect CD4 counts. Lymphocyte counts were assessed in commercial sex workers, symptomatic men and women presenting to the University of Dakar infectious disease clinic for out-patient care and women seeking family planning services. CD4 and CD3 lymphocyte counts differed between the four study groups (P < 0.01). Men had the lowest mean CD4 count (711.6 cells/microl), while commercial sex workers had the highest levels (966.0 cells/microl). After adjustment for age and other behavioural and clinical factors, the difference in CD4 counts between the three groups of women did not remain. However, both gender and smoking were associated independently with CD4 counts, as men maintained lower mean CD4 counts (beta = -156.4 cells/microl, P < 0.01) and smokers had higher mean CD4 counts (beta = 124.0 cells/microl, P < 0.01) than non-smokers in multivariable analyses. This study is the first to explore factors that may influence CD4 levels in Senegal and to estimate baseline CD4 levels among HIV-negatives, information that may guide clinicians in interpreting CD4 counts.
