ArticlePloS one2013
CD4 cell levels during treatment for tuberculosis (TB) in Ethiopian adults and clinical markers associated with CD4 lymphocytopenia.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 45 citations in OpenAlex.
- Future Prospects for Using Clinical Phenotypes in Tuberculosis Precision Medicine-An Approach for Clinical Management.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Review
- Total hip arthroplasty in different types of advanced tubercular hip arthritis: is it justified.International orthopaedics · 2023Article
- LTA4H Prevalence and Mortality in Adult Zambians with Tuberculous Meningitis.Annals of neurology · 2021Article
- Modelling immune deterioration, immune recovery and state-specific duration of HIV-infected women with viral load adjustment: using parametric multistate model.BMC public health · 2020Article
- RNA Sensing ofVaccines · 2020Review
- Prevalence and Predictors of CD4+ T-Lymphocytopenia Among HIV-Negative Tuberculosis Patients in Uganda.Research and reports in tropical medicine · 2020Article
- Prospective Cohort Study on Performance of Cerebrospinal Fluid (CSF) Xpert MTB/RIF, CSF Lipoarabinomannan (LAM) Lateral Flow Assay (LFA), and Urine LAM LFA for Diagnosis of Tuberculous Meningitis in Zambia.Journal of clinical microbiology · 2019Article
- Active tuberculosis in patients with systemic lupus erythematosus from Southern China: a retrospective study.Clinical rheumatology · 2019Article
- Plasma Profiles of Inflammatory Markers Associated With Active Tuberculosis in Antiretroviral Therapy-Naive Human Immunodeficiency Virus-Positive Individuals.Open forum infectious diseases · 2019Article
- Immunological recovery in patients with pulmonary tuberculosis after intensive phase treatment.The Journal of international medical research · 2018Article
- Long-term Outcome of Antiretroviral Treatment in Patients With and Without Concomitant Tuberculosis Receiving Health Center-Based Care-Results From a Prospective Cohort Study.Open forum infectious diseases · 2017Article
- Six-month survival of critically ill patients with HIV-related disease and tuberculosis: a retrospective study.BMC infectious diseases · 2016Article
- Asymptomatic Helminth Infection in Active Tuberculosis Is Associated with Increased Regulatory and Th-2 Responses and a Lower Sputum Smear Positivity.PLoS neglected tropical diseases · 2015Article
- Article
- A Clinical Scoring Algorithm for Determination of the Risk of Tuberculosis in HIV-Infected Adults: A Cohort Study Performed at Ethiopian Health Centers.Open forum infectious diseases · 2014Article
- High rates of virological suppression in a cohort of human immunodeficiency virus-positive adults receiving antiretroviral therapy in ethiopian health centers irrespective of concomitant tuberculosis.Open forum infectious diseases · 2014Article
- CD3, CD4, CD8, CD19 and CD16/CD56 positive cells in tuberculosis infection and disease: Peculiar features in children.International journal of immunopathology and pharmacologyArticle
- The Profile of the Patients with Double Infection HIV and TB in South West of Romania.Current health sciences journalArticle
- Endoscopic Ultrasound-guided Cytodiagnosis of Adrenal Histoplasmosis with Reversible CD4 T-Lymphocytopenia and Jejunal Lymphangiectasia.Journal of cytologyArticle
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe clinical correlations and significance of subnormal CD4 levels in HIV-negative patients with TB are unclear. We have determined CD4 cell levels longitudinally during anti-tuberculosis treatment (ATT) in patients, with and without HIV co-infection, and their associations with clinical variables.
methodAdults diagnosed with TB (maximum duration of ATT for 2 weeks, and with no history of antiretroviral therapy (ART) in HIV-positive subjects) were included consecutively in eight out-patient clinics in Ethiopia. Healthy individuals were recruited for comparison at one of the study health centers. Data on patient characteristics and physical findings were collected by trained nurses following a structured questionnaire at inclusion and on follow-up visits at 2 and 6 months. In parallel, peripheral blood CD4 cell levels were determined. The evolution of CD4 cell levels during ATT was assessed, and the association between clinical characteristics and low CD4 cell levels at baseline was investigated using regression analysis.
resultsIn total, 1116 TB patients were included (307 HIV-infected). Among 809 HIV-negative patients, 200 (25%) had subnormal CD4 cell counts (<500 cells/mm(3)), with <350 cells/mm(3) in 82 (10%) individuals. CD4 cell levels increased significantly during the course of ATT in both HIV+ and HIV- TB-patients, but did not reach the levels in healthy subjects (median 896 cells/mm(3)). Sputum smear status, signs of wasting (low mid upper arm circumference (MUAC)), and bedridden state were significantly associated with low CD4 cell counts.
conclusionA high proportion of Ethiopian TB patients have subnormal CD4 cell counts before starting treatment. Low CD4 cell levels are associated with smear positive disease and signs of wasting. The continuous increase of CD4 cell counts during the course of ATT suggest a reversible impact of active TB on CD4 cell homeostasis, which may be considered in interpretation of CD4 cell counts in HIV/TB co-infected subjects.
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