Use of absolute lymphocyte count or neutrophil ingestion rate of nitroblue tetrazolium (NBT) as alternative index to CD4⁺T-cell count to initiate ART in the management of HIV/AIDS disease

Abstract

The present study was designed to evaluate absolute lymphocyte count or neutrophil ingestion rate of NBT as alternative indices to CD4⁺ T cell count in the management of HIV/AIDS subjects. 158 adult participants (male = 70, female = 88) were recruited for the study and grouped as: (i) Symptomatic HIV subjects with or without malaria (ii) Asymptomatic HIV subjects (iii) HIV seronegative subjects with or without malaria. Blood samples taken from these participants were analyzed using standard procedures for absolute lymphocyte count, neutrophil ingestion rate of NBT and CD4+ T cell count. The result showed that the mean absolute lymphocyte and neutrophil ingestion rate of NBT were significantly reduced in both symptomatic and asymptomatic HIV subjects with or without malaria infection when compared to the control group. The CD4⁺ T cell count was significantly reduced in the two groups and positively correlated with the absolute lymphocyte count (r = 0.301, P<0.05, r = 0.403, P<0.05) and neutrophil ingestion rate of NBT (r = 0.116, P = 0.01, r = 0.359, P<0.01) with or without malaria infection respectively. This finding suggests that in resource limited settings, absolute lymphocyte count or neutrophil ingestion rate of NBT could be used as alternative to CD4 count to monitor or initiate ART where the later is not easily accessible especially in a malaria endemic area.

Keywords: Absolute lymphocyte count, NBT, ART, CD4⁺ T-cell count, HIV