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PubMed1995

CD4+ lymphocyte count in African patients co-infected with HIV and tuberculosis.

The objectives of this study were (a) to compare the CD4+ lymphocyte profiles over time of two groups of patients hospitalized for tuberculosis (TB) treatment [a group of patients with TB only (TB group) and a group dually infected by HIV and TB (HIV/TB group)] and (b) to assess the usefulness of the total lymphocyte count (TLC) as a surrogate of the CD4+ lymphocyte count in the HIV/TB group. A total of 345 patients were enrolled in the study of whom 104 (29.8%) were HIV seropositive (HIV/TB). On admission, the CD4+ lymphocyte counts of the HIV/TB cohort were significantly lower than the TB group with medians of 230 (interquartile range, 90-475) and 630 (500-865), respectively (p < 0.0001). The CD4+ lymphocyte count increased significantly in both cohorts on routine TB treatment. A TLC of 1,300-1,500 cells/mm3 was found to be predictive of a CD4+ lymphocyte count of < or = 200 cells/mm3 both on admission and after 1 month of TB therapy. We conclude from this study that the positive influence of TB therapy on the CD4+ lymphocyte count strongly suggests an additional avenue of influence on the course of HIV infection, whereas the usefulness of the TLC as a surrogate estimation of CD4+ lymphocyte count in HIV/TB patients has important implications for the developing world.

AIDS-Related Opportunistic Infections↗
PubMed2005

Total blood lymphocyte counts in hemochromatosis probands with HFE C282Y homozygosity: relationship to severity of iron overload and HLA-A and -B alleles and haplotypes.

BACKGROUND: It has been reported that some persons with hemochromatosis have low total blood lymphocyte counts, but the reason for this is unknown. METHODS: We measured total blood lymphocyte counts using an automated blood cell counter in 146 hemochromatosis probands (88 men, 58 women) with HFE C282Y homozygosity who were diagnosed in medical care. Univariate and multivariate analyses of total blood lymphocyte counts were evaluated using these variables: sex; age, transferrin saturation, and serum ferritin concentration at diagnosis; units of blood removed by phlebotomy to achieve iron depletion; and human leukocyte antigen (HLA)-A and -B alleles and haplotypes. RESULTS: The mean age at diagnosis was 49 +/- 14 years (range 18 - 80 years) in men and 50 +/- 13 years (range 22-88 years) in women. The correlations of total blood lymphocyte counts with sex, age, transferrin saturation, and serum ferritin concentration at diagnosis, and units of blood removed by phlebotomy to achieve iron depletion were not significant at the 0.05 level. Univariate analyses revealed significant associations between total blood lymphocyte counts and presence of the HLA-A*01, -B*08, and -B*14 alleles, and the A*01-B*08 haplotype. Presence of the A*01 allele, B*08 allele, or A*01-B*08 haplotype were associated with a lower total blood lymphocyte count, whereas presence of the B*14 allele was associated with a greater total blood lymphocyte count. There was an inverse association of total blood lymphocyte count with units of phlebotomy to achieve iron depletion, serum ferritin concentration, and with presence of the A*01-B*08 haplotype. CONCLUSION: We conclude that there is a significant inverse relationship of total blood lymphocyte counts and severity of iron overload in hemochromatosis probands with HFE C282Y homozygosity. The presence of the HLA-A*01 allele or the -B*08 allele was also associated with significantly lower total blood lymphocyte counts, whereas presence of the -B*14 allele was associated with significantly higher total blood lymphocyte counts. In univariate and multivariate analyses, total blood lymphocyte counts were significantly lower in probands with the HLA-A*01-B*08 haplotype than in probands without this haplotype.

Journal Article↗
PubMed1996

Correlation between total and CD4 lymphocyte counts in HIV infection: not making the good an enemy of the not so perfect.

The aim of this study was to assess the correlation and average cost of total lymphocyte count compared with CD4 count as a broad estimate of immunosuppression in HIV-1 infected individuals. Spearman's partial rank correlation were calculated between total lymphocyte count, absolute CD4 count and CD4 per cent stratified by stage of HIV-1 infection for routinely collected samples. Data were collected prospectively from a T cell-subset register combined with clinical data obtained retrospectively from case notes of HIV-infected patients managed at St Mary's Hospital, London 1982-1991. Costing data were obtained through a survey of the departments of haematology and immunology (1989/90 prices). The correlation between 1534 paired absolute lymphocyte count and CD4 lymphocyte count was found to be high (R = 0.76). When analysed by stage of HIV infection, the correlation increased from R = 0.64 for asymptomatic patients, to R = 0.72 for patients with symptomatic non-AIDS HIV infection and R = 0.73 for AIDS patients. Correlations between absolute lymphocyte count and CD4 per cent were considerably weaker: R = 0.41 all paired counts; R = 0.32 for asymptomatic patients; R = 0.25 for symptomatic non-AIDS patients; R = 0.32 for AIDS patients. Average cost was pounds 8 per full blood count compared with pounds 38 per T-cell subset analysis. The high correlation between total and CD4 lymphocyte counts, especially for patients with symptomatic HIV disease, demonstrates the suitability of the use of total lymphocyte count in the absence of CD4 counts. Given the considerably lower prices of total lymphocyte counts compared with T-cell subset analysis, this is particularly relevant for developing countries.

CD4 Lymphocyte Count↗
PubMed1976

Prognostic significance of peripheral lymphocyte counts and carcinoembryonic antigens in colorectal carcinoma.

An association between pretreatment lymphocyte counts and 5-year prognosis was noted in colorectal cancer. Among 188 patients with 5-year follow-up significant difference in survival rates in relation to lymphocyte counts was noted: 61% for patients with counts greater than 2,000/cm, 30% for those with counts less than 1,000/cmm, and 58% for the intermediate group. Similar differences were also noted within groups with Dukes' B and C lesions and in elderly patients. Highly significant differences were noted in women. Those with Dukes' B and C lesions with counts greater than 2,000/cmm had an 81% survival rate, compared to 50% for those with lower counts X2 = 6.81 P LESS THAN 0.01. Women had significantly higher lymphocyte counts and higher survival rates than men. An inverse correlation was noted between pretreatment lymphocytes and simultaneously determined carcinoembryonic antigens. These observations indicate that lymphocyte counts may be of prognostic value in colorectal cancer when used in association with carcinoembryonic antigens.

Aged↗
PubMed1993

Relationship between CD4 lymphocyte count and AIDS mortality, 1986-1991.

OBJECTIVE: To determine the relationship between CD4 lymphocyte count and short-term AIDS mortality, and to determine whether this relationship changed during 1986-1991. DESIGN: A retrospective analysis of CD4 lymphocyte counts in patients dying with AIDS and estimation of median survival in patients with a CD4 count < .50 x 10(6)/l. METHODS: Absolute CD4 lymphocyte count in the 6 months before death was available for 178 patients. The terminal CD4 count was compared in five cohorts of patients dying in 12-month periods from July 1986. Kaplan-Meier survival curves were constructed using survival from date of first absolute CD4 count < 50 x 10(6)/l in 271 patients and compared for each yearly cohort. RESULTS: The median terminal CD4 lymphocyte count for all patients was 10 x 10(6)/l. The median terminal CD4 counts for each yearly cohort were: 1986/1987, 100 (n = 13); 1987-1988, 10 (n = 27); 1988-1989, 10 (n = 30); 1989/1990, 20 (n = 59); 1990-1991, 10 (n = 58). There was a significant difference in the terminal CD4 count in the 1986-1987 period compared with all other years combined, but no further changes after 1987-1988. The median survival of all patients from date of first CD4 count < 50 x 10(6)/l was 11.9 months. There was no significant difference in median survival in each yearly cohort. CONCLUSIONS: There is a close correlation between CD4 lymphocyte count and short-term mortality in AIDS. Therapeutic advances over the past 5 years are not reflected by changes in CD4 count before death or improved survival in patients with very low CD4 counts.

Acquired Immunodeficiency Syndrome↗
PubMed2002

The impact of pregnancy and menopause on CD4 lymphocyte counts in HIV-infected women.

OBJECTIVES: To determine indirectly the effect of changes in levels of reproductive hormones on CD4 lymphocyte counts by investigating the impact of pregnancy and menopause on CD4 lymphocyte counts in HIV-infected women. METHODS: Participants were 382 women with a known interval of HIV seroconversion. Review of questionnaires or patient charts provided information on pregnancy and menopause. A linear regression model with a random intercept and slope, which adjusts for multiple CD4 lymphocyte counts per woman, was applied to estimate the CD4 decline following HIV seroconversion and to evaluate the effect of pregnancy and menopause on the CD4 path. RESULTS: The 382 women had a median age of 25 years at seroconversion and yielded 1428 CD4 lymphocyte counts from 3 to 10 years after seroconversion. At 3 years from seroconversion, 20 women had passed the menopause (i.e., the last menses) and five more subsequently passed this point during follow-up; 25 women had a pregnancy after study entry. Postmenopausal women had lower CD4 lymphocyte counts 3 years after seroconversion than premenopausal women (333 vs 399 x 106 cells/l; P = 0.09), and pregnant women had lower counts than non-pregnant women (375 vs 399 x 106 cells/l; P = 0.36). The monthly CD4 decline was not associated with pregnancy and menopause. Adjustment for age did not change the results. CONCLUSIONS: The results suggest that CD4 lymphocyte counts differ between pre- and postmenopausal women, perhaps because of changes in the level of reproductive hormones in the menopause, but associations were not statistically significant. Pregnancy had no statistically significant effect on CD4 lymphocyte counts.

CD4 Lymphocyte Count↗
PubMed1990

Predicting progression to AIDS: combined usefulness of CD4 lymphocyte counts and p24 antigenemia.

PURPOSE: To investigate the combined usefulness of CD4 lymphocyte counts and human immunodeficiency virus type 1 (HIV-1) p24 antigen in predicting progression to the acquired immunodeficiency syndrome (AIDS). PATIENTS AND METHODS: CD4 lymphocyte counts and HIV-1 p24 antigen status were evaluated over a 4-year period in 518 HIV-1-seropositive men enrolled in the Multicenter AIDS Cohort Study in Chicago. RESULTS: Twenty-six percent (134 of 518) of the HIV-1-seropositive cohort had detectable p24 antigen during the study period. Men with p24 antigenemia experienced a more rapid decline in CD4 lymphocyte counts than men who were persistently p24 antigen-negative (p less than 0.01). Mean CD4 lymphocyte counts at first detection of p24 antigen were 406 and 455 cells/microL for men with incident and prevalent antigenemia, respectively. Antigen was detected in 61% (63 of 103) of the men who progressed to AIDS and in only 17% (71 of 415) of the men who did not (p less than 0.0001). The 4-year estimated cumulative AIDS incidence was 86%, 63%, and 21% for men with entry CD4 counts less than 200, 200 to 399, and 400 or more cells/microL, respectively. Presence of p24 antigenemia was strongly associated with more rapid disease progression within each of these CD4 groupings (p less than 0.0001). CONCLUSION: Our data indicate that p24 antigenemia can first be detected with moderate CD4 cell depletion, is associated with a more rapid decline in the CD4 lymphocyte population, and combined with CD4 lymphocyte counts is useful in identifying individuals at significantly greater risk of disease progression. Our findings provide important information for assessing HIV-1 disease prognosis over a 4-year period.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Absolute lymphocyte count as a predictor of CD4 count.

STUDY OBJECTIVE: To determine whether the absolute lymphocyte count (ALC) (white blood count x lymphocyte percentage) can be used to predict a low CD4 count. METHODS: We conducted a retrospective data analysis of consecutive CD4 count analyses performed between January 1, 1995, through December 1, 1995, at an urban university teaching hospital. Results of consecutive CD4 counts and simultaneously measured ALCs were analyzed from samples obtained in inpatient, clinic, and emergency department settings. The ability of ALC to predict a CD4 count less than 200 cells/mm3 was analyzed by calculating sensitivities, specificities, predictive values, and likelihood ratios for a range of ALC values. RESULTS: Among the 807 samples, 322 results (40%) had a CD4 count less than 200 cells/mm3. The ALC and CD4 count were correlated (r=.69, P<.0001). An ALC less than 1,000 cells/mm3 predicted CD4 counts less than 200 cells/mm3 with a sensitivity of .67 (95% confidence interval .62 to .72), specificity of .96 (.94 to .98), positive predictive value of .91 (.87 to .95), and a negative predictive value of .81 (.78 to .84). An ALC less than 2,000 cells/mm3 predicted CD4 counts less than 200 cells/mm3 with a sensitivity of .97 (.95 to .99), specificity of .41 (.37 to .45), positive predictive value of .52 (.48 to .56), and negative predictive value of .95 (.92 to .98). CONCLUSION: A reliable relationship exists between ALC and CD4 count. In a similar population, an ALC less than 1,000 cells/mm3 is predictive of a CD4 count less than 200 cells/mm3, and an ALC greater than or equal to 2,000 cells/mm3 is predictive of a CD4 count greater than or equal to 200 cells/mm3. Physicians may find these criteria useful in identifying patients with increased risk of opportunistic infection.

AIDS-Related Opportunistic Infections↗
PubMed1976

Prognostic value of peripheral lymphocyte count in hormone therapy of advanced breast cancer.

Peripheral lymphocyte counts were performed on 41 patients with advanced breast cancer, before starting treatment with oestrogens or androgens. Patients were seen at monthly intervals, and the response to treatment was independently assessed, using the criteria of the British Breast Group. In the patients treated with oestrogens and androgens, the successful responders were found to have significantly higher pre-treatment peripheral lymphocyte counts than the intermediate responders and failures. It is suggested that pre-treatment peripheral lymphocyte counts may have a prognostic value in assessing potential response to hormone therapy in patients with breast cancer.

Aged↗
PubMed1992

Immunosenescence and mucosal immunity: significant effects of old age on secretory IgA concentrations and intraepithelial lymphocyte counts.

Concentrations of immunoglobulins (Ig) and levels of isotype specific antibodies to three dietary antigens in serum, pure parotid saliva, and in intestinal secretions obtained by whole gut lavage from groups of healthy elderly subjects (aged greater than 70 years) and of younger adult controls (aged 25-50 years) were measured. In addition, counts of lamina propria and intra-epithelial lymphoid cells were performed in histologically normal jejunal biopsy specimens from elderly and younger subjects. Elderly subjects had significantly higher concentrations of serum and salivary IgA and of salivary IgM (both, p less than 0.01), and of salivary IgA antibodies than did the younger subjects, but the amount of immunoglobulin and antibody in whole gut lavage fluid was similar in the two age groups. Jejunal biopsy specimen cell counts showed higher IgA plasma cell counts and lower intraepithelial lymphocyte counts in the elderly group (p less than 0.01), with similar counts of IgM and IgG plasma cells, eosinophils, and mast cells in the two groups. There is evidence of significant effects of old age on the mucosal immune system.

Adult↗
PubMed1999

Brain IL-1beta increases neutrophil and decreases lymphocyte counts through stimulation of neuroimmune pathways.

Leukocytosis after cerebral injury is well described and may participate in the generation of cerebral damage. However, the mechanisms of brain-induced leukocytosis are still speculative. Since it is known that proinflammatory cytokines are involved in neuroimmunomodulation and since others and we have demonstrated high cytokine levels in the cerebrospinal fluid following injury, we supposed that brain cytokines may also influence leukocyte counts. In order to evaluate this hypothesis, we established an animal model using continuous intracerebroventricular (i.c.v.), intrahypothalamic (i.h.), or intravenous infusion of the proinflammatory cytokines tumor necrosis factor (TNF)-alpha and IL-1beta. Controls received vehicle solution. With this experimental paradigm we could show that i.c.v. and i.h. infusion of IL-1beta but not TNF-alpha dramatically increased neutrophil counts, whereas lymphocytes dropped. Blocking the hypothalamic-pituitary-adrenal (HPA) axis by hypophysectomy abolished the neutrophilia, whereas the lymphopenia remained unchanged. Furthermore, application of the beta2-adrenoreceptor antagonist propranolol prevented the decrease of lymphocytes and diminished the neutrophilia. All parameters normalized within 48 h after termination of infusion. So, our results demonstrate that brain IL-1beta can modify blood leukocyte counts through stimulation of both the sympathetic nervous system (SNS) and the HPA axis.

Adrenergic beta-2 Receptor Antagonists↗
PubMed2005

Usefulness of relative lymphocyte count as an independent predictor of death/urgent transplant in heart failure.

The usefulness of low relative lymphocyte count as an independent predictor of death/urgent transplant in patients with heart failure (HF) and the association between low relative lymphocyte count and neurohormone and cytokine activation were investigated. Relative lymphocyte count, clinical variables, neurohormones, and cytokines were measured in 129 outpatients with HF. Follow-up extended to a mean of 3.0 +/- 1.2 years for death/urgent transplant. Low relative lymphocyte count was independently associated with a 3.4-fold increased risk of death/urgent transplant. Relative lymphocyte count was positively associated with hemoglobin and inversely associated with age, jugular venous pressure, creatinine, leukocyte count, and soluble tumor necrosis factor receptor-1. There was only a borderline inverse association with cortisol levels during evening hours.

Biomarkers↗
PubMed1974

Cellular immunity, peripheral blood lymphocyte count and pathological staging of tumours in the gastrointestinal tract.

The peripheral blood lymphocyte count has been measured in 74 cases of histologically proven carcinoma of the gastrointestinal tract. The count has been correlated with the pathological stage of tumour spread and the patient's delayed hypersensitivity response to 2.4 dinitrochlorobenzene (DNCB). A statistically significant correlation was found between the peripheral blood lymphocyte count and the response to DNCB. There was linear association between the extent of spread of the tumours and the lymphocyte count. Those patients with low peripheral blood lymphocyte counts tended to have more advanced tumours and a poor response to DNCB. The possible causes of this lymphopenia are discussed.

Adult↗
PubMed1984

T and B lymphocyte counts and blast transformation in patients with Stage I cervical cancer.

In 57 patients with Stage I cervical cancer and in 25 healthy women, a determination was made of leukocytosis, counts of lymphocytes and monocytes per 1 mm3 of blood, counts of T and B lymphocytes, and PHA-induced lymphocyte ability of in vitro blast transformation. Patients with cervical cancer, as compared with controls, exhibited a decrease in lymphocytosis and in the counts and percentages of T and B lymphocytes, as well as an increase of lymphocyte reactivity to PHA. An increase in the PHA-induced lymphocyte ability of in vitro blast transformation occurred in patients with a clinical picture characterized by the presence of a large tumor of the cervix or of metastases to the lymph nodes of the pelvis. In the group of patients in Stage I with a small cervix the mean indices of blast transformation did not differ from those observed for the healthy control group; on the other hand, in the group of patients with a large cervix and metastases to the lymph nodes of the pelvis, these indices exceeded on the average by about 88% those in the control group.

Adult↗
PubMedDate not supplied

Positive association between total lymphocyte count and femur bone mineral density in hip-fractured women.

BACKGROUND: Protein depletion appears to play a detrimental role in the causes of hip fracture and low bone mineral density has been observed in protein-depleted subjects. OBJECTIVE: To investigate the association between femur bone mineral density and total lymphocyte count, a marker of the protein nutrition status, in elderly hip-fractured women. METHODS: 210 white women affected by their first hip fracture either spontaneous or due to minimal trauma consecutively admitted to a rehabilitation hospital were studied. 34 women were ruled out because of confounding factors altering their lymphocyte count. Both total lymphocyte count and bone mineral density at the unfractured femur were evaluated. The correlation between these two variables was studied by Pearson's coefficient. Bonferroni adjustment was used for multiple comparisons. Bone density was measured by DXA (Hologic QDR 4500W). RESULTS: A positive correlation was observed between lymphocyte count and bone mineral density measured at both total proximal femur (r = 0.21; p < 0.05) and intertrochanteric area (r = 0.21; p < 0.05). Stepwise linear multiple regression analysis showed that the association with total lymphocyte count was independent of age, weight, height, body mass index, time between surgery and blood sample collection for lymphocyte count and type of hip fracture (cervical or trochanteric) when bone mineral density was evaluated both at total proximal femur (p < 0.05) and intertrochanteric area (p < 0.05). CONCLUSION: Our results support the role exerted by protein nutrition in bone health, at least in elderly frail women. From this point of view, a total lymphocyte count is a suitable, inexpensive marker.

Aged↗
PubMed1980

The influence of age on peripheral lymphocyte count in men: a cross-sectional and longitudinal study.

The peripheral lymphocyte count was determined on 436 carefully screened healthy male participants of the Normative Aging Study on three successive determinations over a ten year period. Cross-sectional analysis revealed no significant differences in absolute lymphocyte count between the age groups 23 to 44, 45 to 54, and 55+ years. Longitudinal analysis also showed no significant change in absolute lymphocyte count over the study period. These results indicate that absolute lymphocyte count in healthy men does not change with age.

Adult↗