Some hematological parameters and the prognostic value of CD4, CD8 and total lymphocyte counts and CD4/CD8 cell count ratio in healthy HIV sero-negative, healthy HIV sero-positive and AIDS subjects in Port Harcourt, Nigeria/Nijerya'da (Port Harcourt) saglikli HIV seronegatif, saglikli HIV seropozitif ve AIDS hastasi olgularda CD4, CD8 ve toplam lenfosit sayimi ve CD4/CD8 ....
Abstract: Objective: The present study attempts to determine normal values of CD4, CD8, CD4/CD8 ratio, total WBC and differential counts, hematocrit and total lymphocyte count (TLC) in healthy HIV sero-negative and sero-positive subjects, and to assess the prognostic significance of these parameters in these subjects as compared to AIDS subjects.

Material and Methods: A total of 300 subjects (147 M, 153 F) aged between 17 and 71 years were recruited into the study. Subjects were separated according to sex and divided into three groups: Group A: healthy HIV sero-negative subjects; Group B: healthy HIV sero-positive newly diagnosed ART-naive subjects; and Group C: AIDS subjects. CD4 and CD8 counts were determined by flow cytometry; hematocrit was determined using Hawksley micro-capillary tubes; total WBC and differential counts were determined manually with the improved Neubauer counting chamber; and TLC was obtained by multiplying the percentage of lymphocytes by the total WBC count.

Results: For male subjects, significant differences were found in CD4 count, CD4/CD8 count ratio, hematocrit, total WBC and TLC, whereas for female subjects, significant differences were found only in CD4 and CD4/CD8 count ratio in the three groups of subjects. In both sexes, however, these parameters were found to be highest in healthy HIV sero-negative subjects and lowest in AIDS subjects, with HIV sero-positive subjects having intermediate values.

Conclusion: The results confirm previous reports that the CD4 count and CD4/CD8 count ratio are fairly reliable indicators of the progression of HIV infection. In addition, the results also apparently suggest that the prognostic value of CD8 count is limited and that of TLC possibly sex-dependent. The results could be of importance in our environment since previous reports have been relatively scarce.

Key words: CD4 counts, CD8 counts, CD4/CD8 ratio, total lymphocyte count, human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS).

Amac: Bu calismanin amaci saglikli HIV seronegatif ve seropozitif olgularda normal CD4, CD8 degerleri, CD4/CD8 orani, total lokosit ve periferik yaymadaki kan hucrelerinin sayimlan hematokrit ve total lenfosit sayiminin (TLS) tespit edilmesi ve AIDS olgularina kiyasla bu kisilerde soz konusu parametrelerin prognostik oneminin degerlendirilmesidir.

Yontem ve Gerecler: Onyedi ile 71 yas araligindaki toplam 300 olgu (147 E, 153 K) calismaya alinmistir. Olgular cinsiyete gore ayrilmis ve uc gruba bolunmustur: Grup A: Saglikli HIV seronegatif olgular; Grup B: saglikli HIV seropozitif (yeni teshis edilmis ART-naive) olgular; ve Grup C: AIDS olgulari. CD4 ve CD8 sayimlari akis sitometrisi ile; hematokrit Hawksley mikrokapiler tupler ile; total lokosit ve periferik yaymadaki kan hucrelerinin sayimlari gelistirilmis Neubauer sayim kabi kullanilarak manuel olarak tespit edilmis ve TLS de lenfosit yuzdesinin toplam lokosit sayimi ile carpilmasiyla elde edilmistir.

Bulgular: Uc calisma grubunda erkek olgularla ilgili olarak CD4 sayimi, CD4/CD8 sayiminin orani, hematokrit, toplam lokosit ve toplam lenfosit sayimina yonelik anlamli farkliliklar gozlemlenirken kadin olgularda yalnizca CD4 sayimi ve CD4/CD8 oraninda anlamli farkliliklar bulunmustur. Ancak her iki cinsiyete yonelik olarak bu parametrelerin en yuksek degerleri HIV seronegatif olgularda ve en dusuk degerleri de AIDS olgularinda gozlenmistir. HIV seropozitif olgular ise ara degerlere sahiptir.

Sonuc: Elde edilen sonuclar ile CD4 sayimi ve CD4/CD8 oraninin, HIV enfeksiyonunun gelisimine yonelik oldukca guvenilir gostergeler olduguna dair onceki raporlar onaylanmaktadir. Ayrica elde edilen sonuclar ile, CD8 sayimi prognostik degerinin sinirli oldugu ve toplam lenfosit sayiminin ilgili degerinin ise cinsiyete bagli oldugu acikca ileri surulmektedir. Onceki raporlar nispeten sinirli oldugundan elde edilen sonuclar son derece onem tasimaktadir.

Anahtar kelimeler: CD4 sayimi, CD8 sayimi, CD4/CD8 orani, toplam lenfosit sayimi, insan bagisiklik yetmezlik virusu (HIV), edinilmis bagisiklik yetmezlik belirtisi (AIDS).
Article Type: Report
Subject: CD4 lymphocytes (Health aspects)
CD4 lymphocytes (Research)
CD8 lymphocytes (Health aspects)
CD8 lymphocytes (Research)
HIV infection (Care and treatment)
HIV infection (Prevention)
HIV infection (Prognosis)
HIV infection (Research)
HIV seroprevalence (Research)
Authors: Dapper, Victor
Emem-Chioma, Pedro
Didia, Blessing
Pub Date: 12/01/2008
Publication: Name: Turkish Journal of Hematology Publisher: Aves Yayincilik Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2008 Aves Yayincilik ISSN: 1300-7777
Issue: Date: Dec, 2008
Topic: Event Code: 310 Science & research
Geographic: Geographic Scope: Nigeria Geographic Code: 6NIGR Nigeria
Accession Number: 195681337
Full Text: Introduction

Since its identification in 1981, human immunodeficiency virus (HIV) infection and the associated acquired immunodeficiency syndrome (AIDS) remain a major health burden globally. Recent estimates indicate that over 35 million people are affected worldwide, with mortality counts of over 20 million [1]. About 70% of these deaths have occurred in sub-Saharan Africa [1], where the burden of disease is high and poverty an important accomplice. In Nigeria, the current national average HIV sero-prevalence rate is estimated at about 4.4%, with Rivers State predictably having a higher rate of 5.4% [2]. This is possibly so following the recent rapid urbanization of Port Harcourt, the capital of Rivers State, due to influx of multinational concerns involved with petroleum exploitation and exploration [3].

In individuals with HIV infection, assessment of [CD.sub.4] and [CD.sub.8] cell counts is fairly common and they are routine indices for the evaluation of immune status and decision to initiate anti-retroviral drug therapy (ART) [4]. The [CD.sub.4] cell counts of healthy HIV sero-negative Caucasians have been reported to be between 500 and 1500 cells/[micro]l, while the [CD.sub.8] cell count ranges lower, between 300 and 1000 cells/[micro]l [5]. However, significant geographical and racial differences have been reported in [CD.sub.4] count between Asians and Caucasians [6] and even amongst healthy Africans of different countries [7-9]. Racial differences have also been established in white blood cell (WBC) counts between Africans and Caucasians, with a leuko-neutropenia seen in the Africans [10].

With recent up-scaling of ART in developing countries, including Nigeria, and the resultant anticipated increase in the number of individuals accessing ART, determination of [CD.sub.4] cell count would expectedly become more frequent in Nigeria. However, with the relatively high cost of [CD.sub.4] cell count determination, total lymphocyte count (TLC) has been suggested as an alternative in situations where facilities for [CD.sub.4] cell count are not readily available or resources are limited. This is because TLC is easily obtained from routine complete blood cell counts by multiplying the percentage of lymphocytes by the WBC count [11,12]. However, a number of reports have suggested an inconsistency in the correlations between total lymphocyte and [CD.sub.4] cell counts [13].

Given that, in our environment, reports on this subject are relatively scarce, the present study attempted to determine values of [CD.sub.4], [CD.sub.8], total lymphocyte, total WBC and differential cell counts in healthy HIV sero-negative, healthy HIV sero-positive and in persons with AIDS. The study also determined the [CD.sub.4]/[CD.sub.8] cell count ratio and attempted to assess the possible prognostic value of these parameters using these three groups of subjects. In addition, the study attempts to establish normative values of these parameters, in our environment, for healthy HIV sero-negative and healthy HIV sero-positive subjects who have yet to commence ART. This could possibly assist Nigerian physicians with the assessment and management of HIV infection in affected individuals.

Materials and Methods

Subjects: A total of 300 subjects (147 M, 153 F; age range: 17-71 years) were recruited into the study. Subjects were separated according to sex and were further divided into three groups: Group A [controls] consisted of healthy HIV sero-negative subjects, Group B consisted of healthy HIV sero-positive subjects, and Group C consisted of AIDS subjects. Groups B subjects were newly diagnosed subjects yet to commence ART. Groups B and C were attending the HIV clinic of a tertiary health care facility in Port Harcourt, southeastern Nigeria; Group A [control] subjects were apparently healthy staff and students of the University of Port Harcourt, Nigeria. Each control subject was examined and no evidence of acute or chronic infections or any hematologic, cardiovascular or metabolic disease likely to influence any of the hematological parameters under investigation was found. All subjects gave informed consent before recruitment into the study; ethical clearance was obtained from our institutional ethics committee. All pregnant female subjects were excluded from the study.

Methods: Five milliliters of venous blood was collected from each subject from an antecubital vein with the subject comfortably seated and with minimum stasis. The blood was immediately transferred into EDTA specimen bottles and carefully mixed. All blood specimens were collected between 9 a.m. and 12 noon each day and analyzed within 2 hours of collection.

The HIV status of each subject was determined routinely using the Chembio HIV 1/2 Stat-pak assay kit (Chembio Diagnostic Systems Incorporated, USA). The [CD.sub.4] cell and the [CD.sub.8] cell counts were both determined by flow cytometry using the Partec Cytoflow counter FMC system (Partec GmbH, 2006).

[CD.sub.4]/[CD.sub.8] count ratio for each subject was obtained from the product of dividing the [CD.sub.4] cell count by the [CD.sub.8] cell count. Hematocrit was determined using Hawksley micro-capillary tubes centrifuged at 3000 rpm for 10 minutes; the mean of two separate readings was taken as the hematocrit value. Total WBC and differential WBC counts were determined manually using the improved Neubauer counting chamber [14]. TLC was obtained by multiplying the percentage of lymphocytes by the total WBC count [11,12].

Statistics: The results obtained are expressed as means [+ or -]standard errors of means (SEM); ranges are in parenthesis. Statistical significance was determined using the analysis of variance (ANOVA) or the Student's t-test as appropriate. A p value less than 0.05 (p<0.05) was considered statistically significant.

Results

The results obtained from the present study for each Group are as shown in Tables 1 and 2 for male and female subjects, respectively.

Table 1 presents the ages, [CD.sub.4] and [CD.sub.8] counts, [CD.sub.4]/[CD.sub.8] count ratio, hematocrit, total WBC count, percentage neutrophil, lymphocyte, monocyte, eosinophil and basophil, and TLC for the male subjects involved in the present study. ANOVA showed that significant differences existed in [CD.sub.4] cell count, [CD.sub.4]/[CD.sub.8] cell count ratio, hematocrit, total WBC count and TLC for male subjects between the three groups under consideration: healthy HIV sero-negative subjects (Group A), healthy HIV sero-positive subjects (Group B) and AIDS subjects (Group C) (p<0.05). Each of these parameters was generally the highest in the healthy HIV sero-negative subjects (Group A) and lowest in the AIDS subjects (Group C), with healthy HIV sero-positive subjects (Group B) having intermediate values.

Similarly, Table 2 presents the values of the investigated parameters in all the female subjects involved in the present study. ANOVA showed that significant differences existed only in [CD.sub.4] cell count and [CD.sub.4]/[CD.sub.8] cell count ratio for the three female groups under consideration (p<0.001). Unlike for male subjects, in female subjects, no significant differences were found in hematocrit, total WBC count and TLC between the three groups under consideration (p>0.001). However, as in male subjects, both [CD.sub.4] cell count and [CD.sub.4]/[CD.sub.8] cell count ratio were highest in the healthy HIV sero-negative subjects (Group A) and lowest in the AIDS subjects (Group C), with healthy HIV sero-positive subjects (Group B) having intermediate values.

Amongst the HIV sero-positive (Group B) subjects, 8 (21.6%) males and 26 (41.3%) females had [CD.sub.4] cell counts less than 350 cells/[micro]l. All the AIDS (Group C) subjects were found to have [CD.sub.4] cell counts less than 350 cells/il. None of the healthy HIV sero-negative (Group A) subjects had [CD.sub.4] cell counts less than 350 cells/[micro]l.

Discussion

The present study presents normative values for [CD.sub.4] cell counts, [CD.sub.8] cell counts, TLC and [CD.sub.4]/[CD.sub.8] cell count ratio in healthy HIV sero-negative and healthy HIV sero-positive male and female subjects in Port Harcourt, Nigeria. Previous studies in this regard have been relatively scarce and have focused on the effects of highly active anti-retroviral therapy (HAART) on [CD.sub.4] cell count [15]; on use of absolute lymphocyte count as a marker of [CD.sub.4] cell count and criteria for initiating ART [16]; and on hematological parameters in HIV-infected Nigerians in Port Harcourt [17].

The [CD.sub.4] cell counts obtained in the present study are in the same range as in a recent report in HIV sero-negative Nigerians [18] and are fairly similar to values reported in Caucasians [5,8], Kuwaitis [19], Indians [20], and Tanzanians [21]. However, the [CD.sub.8] cell counts obtained in the present study are marginally higher than values reported for Caucasians5. The non-significant differences in the [CD.sub.8] cell counts between the three groups is at variance with a recent report from Zaria, northern Nigeria, in which both [CD.sub.4] and [CD.sub.8] cell counts were significantly lower in patients compared to controls [22]. However, the significant differences in the [CD.sub.4] cell counts seen in the present study are consistent with that report, although our values are lower than the [CD.sub.8] cell counts reported in healthy controls [22].

The results of the present study suggest that sex variations apparently do exist in both the pattern of differences and possibly in the prognostic value of the parameters under investigation. For instance, although in both sexes [CD.sub.4] cell count and [CD.sub.4]/[CD.sub.8] cell count ratio consistently showed significant differences in the three groups of subjects, TLC followed a similar pattern only in males. These sex differences in both the TLC and total WBC count seen in the present study are perhaps expected based on the reported sex variations in WBC and neutrophil counts [23] and the reported cyclic variation in WBC population during the normal menstrual cycle [24]. Apparently, menstrual cyclic variations in the WBC count could possibly contribute to obscuring the pattern in females likely leading to a sex distinction. This finding would, however, require further investigation. Perhaps these cyclic variations in females could indeed account for the absence of significant differences in the hematocrit scores in females as opposed to the pattern seen in males. Cyclic changes in the hematocrit scores during the normal menstrual cycle have also been reported by the present authors in Nigerians [25] and have been similarly described in Caucasians [26].

Amongst all the parameters studied, the results of the present study apparently suggest that in our environment, the [CD.sub.4] cell count and [CD.sub.4]/[CD.sub.8] cell count ratio are fairly reliable indicators of the progression of HIV infection in both males and females. This is of possible prognostic value and confirms the findings of previous studies in this regard [27]. The results, however, also suggest that the prognostic value of the [CD.sub.8] cell count is limited and that of TLC is possibly sex-dependent.

From the results of the present study, we suggest that Nigerian physicians consider both the [CD.sub.4] cell count and the [CD.sub.4]/[CD.sub.8] cell count ratio more critically in determining the immune status of persons infected with HIV. In addition, the results suggest that the usefulness of TLC in females is limited and therefore can only be used with some caution in place of both the [CD.sub.4] cell count and the [CD.sub.4]/[CD.sub.8] cell count ratio.

In conclusion, the present study attempsted to report normative values for [CD.sub.4], [CD.sub.8], TLC, and [CD.sub.4]/[CD.sub.8] cell count ratio in healthy HIV sero-negative and HIV sero-positive (ART naive) individuals in Port Harcourt, southeastern Nigeria. In addition, the study reports significantly higher [CD.sub.4] cell and [CD.sub.4]/[CD.sub.8] cell count ratio in healthy HIV sero-negative subjects compared to HIV sero-positive (ART naive) subjects and AIDS subjects. Our results could be of possible prognostic importance and likely assist in the management of individuals infected with HIV in our environment.

Received: May 21, 2008 Accepted: September 17, 2008

Gelis tarihi: 21 Mayis 2008 Kabul tarihi: 17 Eylul 2008

References

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[12.] Badri M, Wood R. Usefulness of total lymphocyte count in monitoring highly active antiretroviral therapy in resource-limited settings. AIDS 2003;17:541-5.

[13.] van der Ryste E, Kotze M, Joubert G, Steyn M, Pieters H, van der Westhuizen M, van Standen M, Venter C. Correlation among total lymphocyte count, absolute CD4+ count and CD4+ percentage in a group of HIV-1 infected South African patients. J Acquir Immune Defic Syndr Human Retrovirol 1998;19:238-44.

[14.] Dacie JV, Lewis SM. Practical Haematology. 7th edition. Edinburgh: Churchill Livingstone, 1991.

[15.] Erhabor O, Ejele OA, Nwauche CA. The effects of highly active antiretroviral therapy (HAART) of stavudine, lamivudine and nevirapine on the CD4 lymphocyte count of HIV-infected Africans: the Nigerian experience. Niger J Clin Pract 2006;9:128-33.

[16.] Erhabor O, Uko EK, Adias T. Absolute lymphocyte count as a marker for CD4 T-lymphocyte count: criterion for initiating ART in HIV infected Nigerians. Niger J Med 2006;15:56-9.

[17.] Erhabor O, Ejele OA, Nwauche CA, Buseri FI. Some haematological parameters in human immunodeficiency virus (HIV) infected Africans: the Nigerian perspective. Niger J Med 2005;14:33-8.

[18.] Aina O, Dadik J, Charurat M, Amangaman P, Gurumdi S, Mang E, Guyit R, Lar N, Datong P, Daniyam C, Kanki P, Abimiku A. Reference values of CD4 T lymphocytes in human immunodeficiency virus-negative adult Nigerians. Clin Diagn Lab Immunol 2005;12:525-30.

[19.] Kaaba SA, Al Fadhli S, Burhamah M, Al Jafar H, Khamis A. Lymphocyte subsets in healthy adult Kuwaiti Arabs with relative benign ethnic neutropenia. Immunol Lett 2004;91:49-53.

[20.] Uppal SS, Verma S, Dhot PS. Normal values of CD4 and CD8 lymphocyte subsets in healthy Indian adults and the effects of sex, age, ethnicity and smoking. Cytometry B Clin Cytom 2003;52:32-6.

[21.] Urassa WK, Mbena EM, Swai AB, Gaines H, Mhalu FS, Biberfeld G. Lymphocyte subset enumeration in HIV seronegative and HIV-1 seropositive adults in Dar es Salaam, Tanzania: determination of reference values in males and females and comparison of two flow cytometric methods. J Immunol Methods 2003;277:65-74.

[22.] Onyemelukwe GC, Musa BO. CD4+ and CD8+ lymphocytes and clinical features of HIV seropositive Nigerians on presentation. Afr J Med Med Sci 2002;31:229-33.

[23.] Bain BJ. Ethnic and sex differences in the total and differential white cell count and platelet count. J Clin Pathol 1996;49:664-6.

[24.] Mathur S, Mathur RS, Goust JM, Williamson HO, Fudenberg HH. Cyclic variations in white cell sub-population in human menstrual cycle: correlations with progesterone and estradiol. Clin Immunol Immunopathol 1979;13:246-53.

[25.] Dapper DV, Didia BC. Haemorheological changes during the menstrual cycle. East Afr Med J 2002;79:181-3.

[26.] Brooks DE, Easthope PL. Rheological characteristics of blood through the menstrual cycle. Biorheology 1981;18:485-92.

[27.] Hoover DR, Graham NM, Chen B, Taylor JM, Phair J, Zhou SY, Munoz A. Effect of CD4+ cell count measurement variability on staging HIV-1 infection. J Acquir Immune Defic Syndr 1992;5:794-802.

Victor Dapper (1), Pedro Emem-Chioma (1), Blessing Didia (2)

(1) Department of Human Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria

(2) Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria

Address for Correspondence: Dr. Victor Dapper, Hematology Research Center, Department of Human Physiology, College of Health Sciences, University Of Port Harcourt PMB 5323, Port Harcourt, Nigeria Port Harcourt, Nigeria Phone: +2348056000570 E-mail: dapperdv2001@yahoo.com
Table 1. Hematological parameters, [CD.sub.4] and [CD.sub.8] counts
and ratio in male HIV sero-negative and sero-positive subjects and
AIDS subjects.

Parameter           Healthy HIV-negative    Healthy HIV-positive
                    subjects [Group A]      subjects [Group B]
                    [n=58]                  [n=37]

Age                 36.98 [+ or -] 0.98     35.68 [+ or -] 0.87
(years)             [18-71]                 [17-63]

[CD.sub.4] count    1019.0 [+ or -] 23.74   545.76 [+ or -] 29.48
(Cells/[micro]l)    [468.0-1609.0]          [58.0-2285.0]

[CD.sub.8] count    701.76 [+ or -] 22.99   896.30 [+ or -] 36.5
(Cells/[micro]l)    [137.0-1420.0]          [144.0-2381.0]

[CD.sub.4]/         1.71 [+ or -] 0.07      0.79 [+ or -] 0.07
[CD.sub.8]          [0.44-5.22]             [0.08-4.07]
count ratio

Hematocrit          40.29 [+ or -] 0.46     31.97 [+ or -] 0.41
(%)                 [30-58]                 [22.0-42.0]

Total               5.56 [+ or -] 0.07      4.74 [+ or -] 0.09
WBC count           [3.90-7.30]             [2.80-8.30]
(Cells/[micro]l)

Neutrophil          59.95 [+ or -] 0.56     57.51 [+ or -] 0.65
count (%)           [45.0-73.0]             [34.0-72.0]

Lymphocyte          39.43 [+ or -] 0.55     40.73 [+ or -] 0.60
count (%)           [26.0-54.0]             [21.0-65.0]

Monocyte            0.21 [+ or -] 0.04      0.22 [+ or -] 0.04
count (%)           [0.0-2.0]               [0.0-2.0]

Eosinophil          0.34 [+ or -] 0.05      0.32 [+ or -] 0.05
count (%)           [0.0-3.0]               [0.0-2.0]

Basophil            0.05 [+ or -] 0.02      --
count (%)           [0.0-1.0]               193.15 [+ or -] 4.62

Total               219.1 [+ or -] 4.09     [86.1-332.0]
lymphocyte          [114.8-340.8]
count
(%Cells/[micro]l)

Parameter           AIDS subjects           Significant
                    [Group C]               differences
                    [n=52]

Age                 41.23 [+ or -] 0.99     No
(years)             [19.0-71.0]             [p>0.05]

[CD.sub.4] count    99.04 [+ or -] 4.36     Yes
(Cells/[micro]l)    [12.0-195.0]            [p<0.05]

[CD.sub.8] count    781.65 [+ or -] 20.47   No
(Cells/[micro]l)    [296.0-1385.0]          [p> 0.05]

[CD.sub.4]/         0.13 [+ or -] 0.01      Yes
[CD.sub.8]          [0.02-0.29]             [p<0.05]
count ratio

Hematocrit          31.02 [+ or -] 0.36     Yes
(%)                 [21.0-38.0]             [p<0.05]

Total               4.45 [+ or -] 0.08      Yes
WBC count           [2.60-7.10]             [p<0.05]
(Cells/[micro]l)

Neutrophil          61.75 [+ or -] 0.53     No
count (%)           [50.0-78.0]             [p>0.05]

Lymphocyte          37.35 [+ or -] 0.56     No
count (%)           [21.0-49.0]             [p>0.05]

Monocyte            0.31 [+ or -] 0.05      No
count (%)           [0.0-2.0]               [p>0.05]

Eosinophil          0.40 [+ or -] 0.05      No
count (%)           [0.0-2.0]               [p>0.05]

Basophil            0.04 [+ or -] 0.02      No
count (%)           [0.0-2.0]               [p>0.05]

Total               168.01 [+ or -] 4.40    Yes
lymphocyte          [72.6-302.4]            [p<0.05]
count
(%Cells/[micro]l)

Values=mean  [+ or -]  SEM, range in parenthesis

Table 2. Hematological parameters, [CD.sub.4] and [CD.sub.8] counts
and ratio in female HIV sero-negative and sero-positive subjects and
AIDS subjects.

Parameter           Healthy HIV- negative   Healthy HIV- positive
                    subjects [Group A]      subjects [Group B]
                    [n= 42]                 [n=63]

Age                 38.93 [+ or -] 1.13     33.86 [+ or -] 0.88
(years)             [17-71]                 [19-71]

[CD.sub.4] count    920.52 [+ or -] 24.10   451.46 [+ or -] 20.23
(Cells/[micro]l)    [528.00-1671.00]        [89.00-1377]

[CD.sub.8] count    834.69 [+ or -] 24.54   804.27 [+ or -] 41.86
(Cells/[micro]l)    [326.00 -1452.00]       [269.00-3943.00]

[CD.sub.4]/         1.23 [+ or -] 0.04      0.67 [+ or -] 0.04
[CD.sub.8]          [0.46-2.41]             [0.15-2.51]
count ratio

Hematocrit          33.45 [+ or -] 0.31     30.49 [+ or -] 0.44
(%)                 [24.00-41.00]           [17.00-44.00]

Total               5.07 [+ or -] 0.10      4.85 [+ or -] 0.11
WBC count           [3.30-7.80]             [2.80-9.80]
(Cells/[micro]l)    64.74 [+ or -] 0.54     61.48 [+ or -] 0.71

Neutrophil          [50.00-78.00]           [37.00-76.00]
count (%)           34.33 [+ or -] 0.56     37.94 [+ or -] 0.75

Lymphocyte          [21.00-48.00]           [22.00-73.00]
count (%)           0.24 [+ or -] 0.04      0.17 [+ or -] 0.04

Monocyte            [0.00-2.00]             [0.00-2.00]
count (%)           0.62 [+ or -] 0.07      0.57 [+ or -] 0.07

Eosinophil          [0.00-4.00]             [0.00-6.00]
count (%)           0.12 [+ or -] 0.03      0.02 [+ or -] 0.01

Basophil            [0.00-2.00]             [0.00-1.00]
count (%)           178.04 [+ or -] 5.33    186.7 [+ or -] 6.14

Total               [84.0-336.0]            [66-489.1]
lymphocyte count
(%Cells/[micro]l)

Parameter           AIDS subjects           Significant
                    [Group C]               differences
                    [n=48]

Age                 31.73 [+ or -] 0.73     No
(years)             [18-65]                 [p>0.05]

[CD.sub.4] count    94.46 [+ or -] 4.43     Yes
(Cells/[micro]l)    [14.00-196.00]          [p<0.05]

[CD.sub.8] count    800.10 [+ or -] 54.88   No
(Cells/[micro]l)    [58.00-5055.00]         [p>0.05]

[CD.sub.4]/         0.19 [+ or -] 0.02      Yes
[CD.sub.8]          [0.02-1.76]             [p<0.05]
count ratio

Hematocrit          30.38 [+ or -] 0.41     No
(%)                 [20.00-44.00]           [p>0.05]

Total               4.82 [+ or -] 0.11      No
WBC count           [2.10-8.50]             [p>0.05]
(Cells/[micro]l)    61.77 [+ or -] 0.62     No

Neutrophil          [43.00-80.00]           [p>0.05]
count (%)           37.46 [+ or -] 0.62     No

Lymphocyte          [20.00-57.00]           [p>0.05]
count (%)           0.21 [+ or -] 0.03      No

Monocyte            [0.00-1.00]             [p>0.05]
count (%)           0.58 [+ or -] 0.06      No

Eosinophil          [0.00-2.00]             [p>0.05]
count (%)           --                      No

Basophil            177.10 [+ or -] 3.84    [p>0.05]
count (%)           [60.9-277.5]            No

Total                                       [p>0.05]
lymphocyte count
(%Cells/[micro]l)

Values=mean [+ or -] SEM, range in parenthesis
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