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T-CD4+ cell count at the date of the HIV diagnosis
Journal of the International AIDS Society volume 13, Article number: P175 (2010)
Some studies state that HIV patients' immunological stage at the date of diagnosis has not been significantly altered in the last few years despite a better access to health care, and the innumerable campaigns for the detection of infection due to HIV. Others come to the conclusion that the mean T CD4+ cells count has been reducing since 1985 but no explanation for this fact has yet been found.
Purpose of the study
Evaluation of the influence of epidemiological parameters and year of diagnosis on the immunological stage of the HIV infected patients at the time of diagnosis.
Retrospective analysis of a random survey of the clinical files of HIV positive patients followed at Hospital de Joaquim Urbano, from 1995 to 2008.
Summary of results
730 files have been analysed. 80.1% of these patients were male and 19.9% female. The average age at HIV diagnosis was 36 years (minimum 14, maximum), 1.9% where under 20 years old and 4.2% over 60 years old. 59.3% were intravenous drug users, 26.6% heterosexuals, 6.2% homosexuals and in 7.3% of the patients the risk factor for acquisition of infection was unknown. Of the total, 38.2% were HIV mono-infected, 48.2% where HIV/HCV; 9.2% HIV/HCV/HBV and 4.4% HIV/HBV co-infected. The global mean T CD4+ cell count at the time of diagnosis was 293/mm3. There were no significant statistical differences (p>0.05) between gender: male 289.5/mm3 and female 305.8/mm3, nor age at the time of diagnosis. The mean TCD4+ cell count was higher in the homosexual patients (391.9/mm3) when compared with heterosexuals (273.9/mm3) and iv drug users (300.7/mm3) (p<0,05). The mean TCD4+ cell count at diagnosis was: 306/mm3 in HIV mono-infected patients, 288.2/mm3 in HIV/HBV, 285.4/mm3 in HIV/HCV and 278.2/mm3 in HIV/HCV/HBV co-infected patients, although these differences are not statistically significant among them. At diagnosis a more severe immunosuppression (CD4<200/mm3) was registered in 48.7% of the male population, 53.8% of patients over 60 years old, 54.1% of the heterosexuals, and 62% of VIH/VHB co-infected. When comparing the mean T CD4+ cell count between 1995-1997 (432/mm3), and 2005-2008 (246/mm3) significant statistical differences were found (p<0.05).
The homosexual group of patients presented a better immunological stage at the date of diagnosis. In the remaining groups there were no significant statistical differences in the immunological stage when the HIV infection.
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Domingues da Silva, A., Mendez, J. & e Castro, R.S. T-CD4+ cell count at the date of the HIV diagnosis. JIAS 13, P175 (2010). https://doi.org/10.1186/1758-2652-13-S4-P175
- Cell Count
- Drug User
- Significant Statistical Difference
- Intravenous Drug User
- Clinical File