Enumeration of CD4 and CD8 T-cells in HIV infection in Zimbabwe using a manual immunocytochemical method

Gomo, Exnevia; Ndhlovu, Patricia D.; Vennervald, B J; Nz, Nyazema; Friis, Henrik

doi:10.4314/cajm.v47i3.8596

Cited by 6 publications

(5 citation statements)

References 2 publications

(3 reference statements)

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“…This study also reported an insignificant association between CD4 cell count and gestational age just like Akinbami et al (2014) and Temmerman et al (1995). However, Gomo et al (2004) showed that gestational age influence CD4 cell count. The distribution of CD8 cell counts and CD4:CD8 for the acutely infected in the present study falls within the reference ranges established by Oladepo et al (2009) and Rungta et al (2008) respectively, nonetheless they tend to have a higher CD8 T cells count as it is essential for control of Toxoplasma gondii infection.…”

Section: Issn: 2616 -0668 Umyu Journal Of Microbiology Researchsupporting

confidence: 76%

T-Cell Mediated Immune Responses in Obstetric Population Acutely Infected With Toxoplasmosis in Kano, Nigeria

Ibrahim, A.,,

Kumurya, A. S.,

Yahaya, H.,

et al. 2017

UJMR

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Toxoplasmosis is a disease caused by an obligate intracellular protozoan parasite Toxoplasma gondii which is endemic worldwide.. There is paucity of reports on the immunological responses of pregnant women to toxoplasmosis in Kano. This study was carried to determine T-cell mediated immune responses in pregnant women with acute toxoplasmosis in Kano and factors associated with seropositivity. A total of 320 blood samples were collected and assayed for anti- Toxoplasma gondii Immunoglobulin M (IgM) antibody using ELISA test kit. Samples were assayed for CD4, CD8, using BDFACSCount and the cytokines interferon-gamma (IFN-ϒ), tumour necrosis factor-alpha (TNF-α) using ELISA test kits while differential leucocytes count was carried out microscopically by Leishman staining technique. The IgM seroprevalence was 24(7.5%) and 296(92.5%) were negative. Associated risk factors were cat ownership and consumption of unwashed vegetables (p values = 0.0014 and 0.001 respectively). Mean CD4, CD8, CD4:CD8 and differential count were within normal range for the study subjects with no statistically significant relationship across trimesters. IFN-ϒ and TNF-α were elevated. Moderate eosinophilia appeared with statistically significant relationship between lymphocyte and neutrophil counts across trimesters ( p value = 0.0278). The immunomodulatory effect of pregnancy does not classically suppress T-cell mediated immune responses as our findings revealed normal but slightly reduced distribution of CD4 and CD8 cell counts with elevated IFN- ϒ and TNF-α. The findings revealed the immune status of the study subjects, as slightly modulated, nonetheless, it is urgent to offer adequate health education programs on toxoplasmosis to pregnant women yet to be infected on how to prevent the infection so as to avoid occurrence of congenital infection.

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Section: Issn: 2616 -0668 Umyu Journal Of Microbiology Researchsupporting

confidence: 76%

T-Cell Mediated Immune Responses in Obstetric Population Acutely Infected With Toxoplasmosis in Kano, Nigeria

Ibrahim, A.,,

Kumurya, A. S.,

Yahaya, H.,

et al. 2017

UJMR

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“…By contrast, another study established a BMI <18.5 kg/m 2 (HR=2.15, 95% CI 1.07-4.3, p=0.03) as an IRIS diagnosis predictor. A parity above five clearly predicted unmasking IRIS, and although there are no clear studies elucidating this fact, one study concluded that gestational age and a parity above four influenced T lymphocyte subset levels [ 15 ], a key phenomenon in IRIS development. The WHO-HIV staging (clinical stage 4) was positive for unmasking IRIS, and as it was the common form of IRIS, these findings are elucidated in studies that report on HIV late presenters [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Paradoxical and Unmasking HIV Immune Reconstitution Inflammation Syndrome in Antiretroviral-Naïve Pregnant Women: A Prospective Cohort Study

Muthuka,

Nyamai,

Oluoch

et al. 2024

Cureus

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Background and aims: Following antiretroviral therapy (ART) initiation, HIV-associated immune reconstitution inflammatory syndrome (IRIS), indicated by an array of opportunistic infections, may occur, presenting as either paradoxical, a worsening of a previously treated infection, or unmasking, a flare-up of an underlying, previously undiagnosed infection. The impact of ART as the backbone of HIV treatment and prevention has prolonged the survival of people living with HIV. In pregnancy, benefits have been shown by slowing HIV progression and preventing perinatal transmission; however, there have been risks of adverse reactions with ART, including immune responses to both the fetus and mother. This study sought to estimate the incidence of HIV-IRIS cumulatively and by type either paradoxical or unmasking IRIS, determine the baseline maternal and HIV clinical markers as predictors of, and analyze the log-rank test for survival time to IRIS outcome assessed by relying on an increase in CD4 count and/or a rapid decrease in viral load. Methods: An active records study was conducted between June 2019 and March 2020 among ART-naïve pregnant women attending the antenatal care units (ANCu) at the Kenyatta National and Mbagathi Hospitals, Nairobi, Kenya. Participants were aged between 20 and 49 years and had a confirmed HIV-positive test. To ascertain a true case of IRIS, the diagnosis was adjudicated for accuracy and consistency by an independent review committee. Plasma HIV viral load, CD4 counts, and routine laboratory evaluations (hemoglobin, white blood cell count (WBC)) were performed by each hospital's clinical laboratory. The IRIS incidence was assessed using the International Network for Studies Against HIV-Associated IRIS (INSHI) during the first three months after ART initiation. Multivariate Cox regression with IRIS as the outcome, using the SPSSSurvival package, examined the relationship between baseline maternal characteristics and HIV clinical markers before ART initiation and IRIS, and finally, decision-tree analysis for predicting IRIS was performed. Results: From a pool of 532 ART-naïve pregnant women, 133 (25%) developed IRIS, and 97 (72.9%) were in the unmasking category. The accumulated risk of experiencing IRIS symptoms increased from week two (hazard ratio (HR)=0.0287) to week 12 (HR=3.6158). Participants with a maternal BMI (MBMI) of 25-29.9 kg/m 2 at baseline were at a higher risk of unmasking IRIS (HR=2.478; P=0.010). The WHO-HIV clinical stages 1 and 2 skewed towards paradoxical IRIS (regression coefficients =-0.111 and -0.276 (P<0.05)), while stage 4 skewed towards unmasking IRIS (regression coefficient=0.047, HR=1.048, P=0.941). A CD4 count > 500 cells/mm^3 skewed towards unmasking IRIS (regression coefficient=0.192, HR=1.211, P=0.416), while RNA-HIV viral loads >50 copies/ml towards paradoxical IRIS (regression coefficient=-0.199, HR=0.820, P=0.360. On decision tree analysis, 85% (P=0.001) of ART-naïve pregnant women with a baseline CD4 count...

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“…Maternal Basal Metabolic Index (MBMI) of (25 -29.9) clearly predicted unmasking IRIS as depicted is a study that established BMI ≥20 kg/m 2 as probable predictor of IRIS 27,38 , contrary to another study that established BMI <18.5 (HR 2.15, 95% CI 1.07-4.3, p = 0.03) as IRIS diagnosis predictor. Gravidity of above 5 clearly predicted unmasking IRIS and although there are no clear studies elucidating this fact, a study concluded that, gestational age, and gravidity of above 4 influenced T lymphocyte subset levels 39 , a key phenomenon in IRIS development. WHO-HIV Staging (clinical stage 4) was positive with unmasking IRIS, and as it was the common form of IRIS, this findings are elucidated in a studies that report HIV late presenters 40,41 .…”

Section: Discussionmentioning

confidence: 99%

Incidence and Clinical Parameters of HIV-1 Paradoxical and Unmasking Immune Reconstitution Syndrome in Antiretroviral Naïve Pregnant Women attending selected facilities in Kenya

Muthuka K.,

Nyamai M.,

Kelly J.

et al. 2023

Preprint

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BackgroundFollowing ART initiation, a spectrum of HIV-associated immune reconstitution inflammatory syndrome (IRIS), as opportunistic infections occurs, presenting as either paradoxical or unmasking IRIS. There are benefits of ART for maternal health and prevention of perinatal transmission, however, some risks may be possible with IRIS. The study sought to estimate the incidence, compare survival times to, and investigate the baseline clinical predictors of HIV-1 paradoxical and unmasking IRIS as well as identify the homogeneity defined by combinations of specific covariates in Art Naïve Pregnant Women.MethodsA prospective, active records observational study [P609/08/-2018-E] was conducted among ART-naive pregnant women attending antenatal care unit (ANCu) from Kenyatta National andMbagathiHospitals in Kenya. Participants enrolled were between the ages of 20 - 49 years with a clear documentation of HIV status and, an independent review committee adjudicated IRIS diagnosis. Associations between baseline pre-ART characteristics, biomarkers, and IRIS diagnosis were assessed with Cox models. Decision-tree analysis was finally performed to identify homogeneity defined by combinations of specific parameters.ResultsOf the initial total 532 women, (24.8%) (n=133) participants experienced IRIS by the 12thweek post ART initiation, 27.3 % (n= 36) and 72.7% (n = 96) paradoxical and unmasking respectively. Maternal Basal Metabolic Index (MBMI) of (25 -29.9) significantly predicted unmasking IRIS [(β)=0.907, Wald test (β^) = 6.550, (HR = 2.478, 95% C.I 1.237 – 4.965, P = 0.010] same case to gravidity of above 5 [(β)=0.743, P = 0.338] while that of 2-3 predicted paradoxical IRIS [(β)= - 0.542, P = 0.037. WHO-HIV clinical stage 1 and 2 showed a link towards paradoxical IRIS, [(β)=- 0.111 and (β)= - 0.276 (P < 0.05)], clinical stage 4 with unmasking IRIS [(β)= 0.047, HR = 1.048, P = 0.941]. CD4 count > 500 cells/mm3skewed towards unmasking IRIS diagnosis [(β)= 0.192, HR = 1.211, P = 0.416], while RNA-HIV viral loads > 50 copies/ml towards paradoxical IRIS [(β)= - 0.199, HR = 0.820, P = 0.360. On decision tree analysis, 76% (P = 0.729) of ART naïve pregnant women aged 20-29 and 40-49 years of age presented with unmasking IRIS and a gravidity of 4-5 and 1 predicted 88% (P = 0.045) unmasking IRIS as compared to that of 2-3 62 % (P = 0.045).ConclusionUnmasking IRIS was the common type of IRIS post-ART initiation. Maternal BMI and RNA-HIV viral loads level predicted paradoxical IRIS while the baseline CD4 count and WHO-HIV clinical infection stage 1 and 4 were associated with unmasking IRIS. Gravidities of 1 and 4 – 5 predicted unmasking IRIS.

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Enumeration of CD4 and CD8 T-cells in HIV infection in Zimbabwe using a manual immunocytochemical method

Cited by 6 publications

References 2 publications

T-Cell Mediated Immune Responses in Obstetric Population Acutely Infected With Toxoplasmosis in Kano, Nigeria

T-Cell Mediated Immune Responses in Obstetric Population Acutely Infected With Toxoplasmosis in Kano, Nigeria

Paradoxical and Unmasking HIV Immune Reconstitution Inflammation Syndrome in Antiretroviral-Naïve Pregnant Women: A Prospective Cohort Study

Incidence and Clinical Parameters of HIV-1 Paradoxical and Unmasking Immune Reconstitution Syndrome in Antiretroviral Naïve Pregnant Women attending selected facilities in Kenya

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