Normal CD4 T-lymphocyte baseline in healthy HIV-negative pregnant women

The CD4 count is frequently used as a surrogate marker for immune suppression associated with HIV infection and to monitor antiretroviral treatment. The aim of this study is to establish the normal reference values of CD4 count in healthy pregnant women in our environment. Pregnant women attending the antenatal clinic of the University of Maiduguri Teaching Hospital (UMTH) received voluntary counselling and testing for HIV. Those who tested negative had their CD4 count assessed using the cyflow method. Healthy non-pregnant women attending the family planning clinic of the UMTH as well as healthy men coming to donate blood at the blood bank of the same hospital were recruited as controls. A total of 128 pregnant women, 228 non-pregnant women and 185 men were recruited for the study. The mean CD4 count of the pregnant women was 751.41 cells/microl which was significantly lower than the mean CD4 count of 869 cells/microl for the non-pregnant women. Primigravidas had a lower mean CD4 count than both multiparas and grandmultiparas. Similarly, the mean CD4 count was higher in the first trimester than in the later parts of pregnancy. There was no significant difference in the mean CD4 count across all age groups. There is a slight fall in the mean CD4 count in pregnancy, which is more in the first trimester of pregnancy and in primigravidas. This should not affect the reference values for the initiation of antiretroviral drugs in pregnancy.