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Population specific reference ranges of CD3, CD4 and CD8 lymphocyte subsets among healthy Kenyans
Erick M Bosire1, Anthony K Nyamache, Michael M Gicheru
1Department of Zoological Science, Kenyatta University, P,O, Box 43844-0100, Nairobi, Kenya. bosireerick@yahoo.com.
Insights
This study establishes CD4 and CD8 T-lymphocyte reference ranges for healthy Kenyans, crucial for HIV management. Findings reveal variations across age, sex, and regions, differing from European populations.
Area of Science:
- Immunology
- Clinical Diagnostics
- Public Health
Background:
- Absolute CD4 T-lymphocyte counts are critical for managing various medical conditions, particularly HIV infection, guiding treatment initiation.
- Established CD4/CD8 T-lymphocyte count ranges vary significantly across different global populations.
- Comprehensive CD4/CD8 T-lymphocyte reference ranges specific to the Kenyan population were previously lacking.
Purpose of the Study:
- To determine and establish reference ranges for CD4 and CD8 T-lymphocytes in a healthy Kenyan population.
- To provide essential data for accurate clinical interpretation of lymphocyte counts within Kenya.
Main Methods:
- Recruited 315 healthy individuals aged 16-60 years from five distinct Kenyan regions.
- Screened participants for conditions affecting lymphocyte homeostasis.
- Utilized a FACSCalibur flow cytometer for CD4/CD8 T-lymphocyte enumeration, analyzing results by age, sex, and region.
Main Results:
- Established general population reference ranges: CD3 1655 (614-2685), CD4 920 (343-1493), CD8 646 (187-1139) cells/μL.
- Reported sex-specific ranges: Females CD4 1010 (422-1572), Males CD4 889 (320-1459) cells/μL.
- Determined CD4/CD8 ratios: General population 1.57 (0.50-2.74), Females 1.69 (0.55-2.95), Males 1.51 (0.49-2.64).
Conclusions:
- Kenyan CD4/CD8 T-lymphocyte reference ranges are comparable to other African populations but differ from European ranges.
- Significant variations in lymphocyte counts were observed between different regional clusters within Kenya.
- Notable differences in CD4/CD8 T-lymphocyte ranges were identified between males and females in the Kenyan population.
Background:
The enumeration of absolute CD4 counts is of primary importance for many medical conditions especially HIV infection where therapeutic initiation depends on the count. These ranges tend to vary across populations. However, these ranges have not been comprehensively established in the Kenyan population. Therefore, this study aimed at establishing the reference ranges for the CD4 and CD8 T-lymphocytes in normal healthy individuals in Kenya.
Methods:
A total of 315 individuals of the ages between 16 and 60 years old, in 5 different regions of the country, were recruited into the study. They were screened for diseases that potentially cause lymphocyte homeostasis perturbation. CD4/CD8 Counts were performed by use of a FACSCalibur flow cytometer (Becton-Dickinson, NJ) equipped with automated acquisition and analysis software. Results were analysed according to age, sex and region.
Results:
Results were presented as means and ranges (in parenthesis) generated non parametrically as 2.5 and 97.5 percentiles as follows; In general population; CD3 1655 (614-2685 cells/μL ), CD4 920 (343-1493 cells/μL), and CD8 646 (187-1139 cells/μL), while according to sex, females; CD3 1787 (697-2841 cells/μL), CD4 1010 (422-1572 cells/μL), CD8 659 (187-1180 cells/μL); males; CD3 1610 (581-2641 cells/μL), CD4 889(320-1459 cells/μL) and CD8 644 (185-1140 cells/μL). The general reference ranges for CD4/CD8 ratios were as follows; general population 1.57(0.50-2.74), males 1.51(0.49-2.64) and females 1.69(0.55-2.95).
Conclusion:
The lymphocyte reference ranges for the Kenyan population are fairly comparable to those established in other African populations. The ranges also differ appreciably from those established in Germany, Italy and Switzerland. Furthermore, the study reported significant differences in the ranges of different population clusters within Kenya, as well us between males and females.
