Determination of normal cd4+ lymphocyte values and its association with total leucocyte count in normal adult nigerians resident in Maiduguri, Nigeria

Background: Determination of normal CD4 count and understanding the total lymphocyte count (TLC)-CD4 count relationship could assist in making clinical decisions during antiretroviral therapy, especially in underserved resource-poor settings. The aim of this study is to establish the normal reference values of CD4 count in healthy HIV negative adults residing in our environment. Methods: Three hundred and eighty four apparently healthy adult participants who presented at the HIV clinic for HIV counselling and testing (HCT) between March 2009 and January 2010 were equally recruited based on sex into the study. Those that tested negative had their CD4 count and TLC assessed using cy flow method and hematology analyzer. Result: Their ages at presentation ranged from 18- 67 years (males, 18–49 years; females, 18–67 years) total mean age was 27.29 years (SD = 6.92 years). The male´s mean age of (27.43 years, SD = 5.95 years) was similar to (27.15 years, SD = 7.7 years) in females (p > 0.05). The participants’ CD4 cell count at presentation ranged from 247-1840cells/µl with a mean of 766.66 (SD = 245.69 cells/µl). Mean CD4 cell count at presentation was significantly higher in females (828.41 cells/µl, SD = 268.68cells/µl) than in males (704.26cells/µl, SD =202.37 cells/µl) (f=22.82, p = 0.000). The mean ± SD (min-max) TLC of the studied participants was 5.26 ±1.97 (1.2-14.3). The mean TLC was similar in females (4.94x109/l, SD = 1.95 and males (5.57x109/l, SD =1.97) (p = 0.9). The mean CD4 counts of subjects were similar across the different groups. Similarly there was no statistically significant difference in the mean TLC across all the groups. A positive correlation was observed between CD4 count and TLC (r=0.36, p=0.000). Conclusion: This study shows that females have higher CD4 count than males. There was no observed difference in mean CD4 count across all age groups. A positive correlation was observed between CD4 count and TLC (r=0.36, p=0.000); this association shows that TLC is a suitable surrogate marker for CD4 count in normal adults in our environment.