CD4+ cell counts in patients with different clinical manifestations of tuberculosis

Abstract

Tuberculosis is the prototype of infections that require a cellular immune response for their control. It has been shown that CD4+ T-lymphocytes are most important in the protective response against Mycobacterium tuberculosis. CD8+ T-lymphocytes are also important for effective T-cell immune response. This study compares CD4+ and CD8+ baseline values in patients with different manifestations of tuberculosis. CD4+ and CD8+ in three groups of patients with tuberculosis (pulmonary, lymphadenitis, meningitis/milliary involvement) and a group of healthy volunteers were enumerated using flowcytometry. Twenty-six patients with pulmonary tuberculosis, 10 with adenitis, 16 with meningitis or milliary tuberculosis and 16 healthy volunteers entered the study. Mean CD4 in meningitis/ milliary group was significantly lower than all other groups (p<0.05). Mean CD4 counts of patients with pulmonary tuberculosis was also significantly lower than control group (p=0.01). Mean CD8 in meningitis/milliary group was significantly lower than control group (p=0.02). No relation was found between results of TSTs and CD4 values in three groups. CD4 depletion is an expectable phenomenon in patients with tuberculosis. This study shows that patients with more severe form of disease had the lowest number of both CD4 and CD8 cells which can be a sign of suppressed cellular immunity in these patients.

Comparison of CD4 and CD8 counts and ratio in HIV negative pulmonary tuberculosis patients with normal healthy controls

“…In a study by Han Pin Kuo et al, in the BAL of HIV negative TB patients, they observed significant increase in the CD4:CD8 ratio with respect to normal subjects (2.8±0.4 versus 1.3±0.2, p=0.03) which was similar to results reported by Singhal et al 17,18 This finding is contrary to that observed by Ashtekar MD et al, Uppal et al and Davoudi et al, who reported significant reduction of the CD4:CD8 ratio which can be due to CD8 lymphocytosis with CD4 lymphopenia. 6,13,19 …”

Disseminated cutaneous herpes zoster in an immunocompetent elderly patient

“…7 After performing additional literature review, milliary tuberculosis (TB) was also added to the immunosuppressive conditions, as it has been associated with T cell deficiency. 8 DCHZ was defined as >20 skin lesions beyond the primary or adjacent dermatomes. 9 Sixteen related publications were identified.…”

A case of tuberculous gumma: there is more to it than meets the eye

“…The CD4 count in our case was less than normal (500–1500 cells/mm 3 ) but it did not fulfil the criteria for CD4 lymphopenia. The explanation for this may be that TB itself may lead to low CD4 count as has been shown in previous studies 11. We could not investigate for the interferon gamma and interleukin 12 pathway which when deficient or ineffective may lead to MSMD.…”