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T-lymphocyte subsets in acute illness

C Feeney1, S Bryzman, L Kong

  • 1Department of Internal Medicine, Highland General Hospital, Oakland, CA 94602-1018, USA.

Critical Care Medicine
|October 1, 1995
PubMed
Summary
This summary is machine-generated.

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Acute illness can cause significant decreases in T-lymphocyte subsets, even without HIV infection. These changes in CD4, CD8, and CD4/CD8 ratios do not correlate with illness severity or survival rates.

Area of Science:

  • Immunology
  • Critical Care Medicine

Background:

  • T-lymphocyte subsets, including CD4 and CD8 cells, are crucial for immune function.
  • Changes in these subsets are typically associated with conditions like HIV infection, but their role in acute illness is less understood.

Purpose of the Study:

  • To investigate the range of T-lymphocyte subsets (CD4, CD8, CD4/CD8 ratios) in acutely ill hospitalized patients.
  • To determine if these T-lymphocyte subset levels correlate with illness severity, survival, or immunodepression.

Main Methods:

  • A cross-sectional study was conducted in an urban county hospital intensive care unit (ICU).
  • One hundred two consecutively admitted ICU patients (72 medical, 30 surgical) were assessed.
  • T-lymphocyte subsets were measured and compared with Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and predicted mortality rates.

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Main Results:

  • Despite a low prevalence of HIV (2.9%), a significant proportion of patients exhibited low CD4 counts (<400 cells/microL in 41%, <300 cells/microL in 29%).
  • Mean CD8 concentrations were lower than normal, leading to a slight increase in CD4/CD8 ratios, with 16% having a ratio <1.
  • No correlation was found between T-lymphocyte subset counts and APACHE II scores, predicted mortality, or survival rates.

Conclusions:

  • Acute illness, independent of HIV infection, can lead to substantial reductions in T-lymphocyte populations.
  • These T-lymphocyte alterations are unpredictable and do not correlate with illness severity or patient survival.
  • Single measurements of T-cell concentrations are insufficient to determine HIV serostatus or predict survival in acutely ill patients.