Effect of HIV Infection and Antiretroviral Therapy Duration on CD4 Count, Total and Differential White Cell Count

Aims: To assess CD4 counts, total and differential white cell counts in HIV positive patients on antiretroviral treatment (ART) and those not on antiretroviral treatments with varying durations of infection.

Study Design: Case-control study.

Place and Duration of Study: Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria from March to August 2013.

Methodology: We included 181 subjects; sixty HIV patients on ART with infection duration of <1 – 5, >5 – 8 and >8 – 17 years and ART duration of <1 – 5, >5 – 8 and >8 – 17 years; sixty HIV patients not on ART with an infection duration of <1 – 3, >3 – 6 and >6 – 11years; and sixty-one apparently healthy individuals control. CD4 counts, total and differential white cell counts as well as Human Immunodeficiency virus (HIV) status were determined.

Results: CD4 counts was significantly higher in the control compared to the ART and non-ART and lower in HIV duration of <1 – 3 years compared to >3 – 6 years and >6 – 11 years (P<0.05). TWBC was significantly higher in non-ART compared to ART and control (P<0.05). MXD was significantly lower in control compared to ART and non-ART (P<0.05). NEUT was significantly higher in non-ART than control while LYM was higher in non-ART than ART (P<.05). TWBC was lower in <1 -3 years than >6 – 11 years both in non-ART subjects (P<.05) TWBC was also higher in female controls than male (P<.05).

Conclusion: CD4 count is generally lower in HIV subjects. TWBC is elevated in non-ART, while MXD is higher in ART and non-ART subjects. There is no difference in white cell parameters for ART subjects irrespective of differences in duration of HIV infection and antiretroviral therapy.