CD4+ lymphocyte values and trends in individuals infected with Human Immunodeficiency Virus and/or co-infected with Hepatitis C Virus in The Gambia

Objectives: This study was undertaken to monitor the CD4+ lymphocyte count in individuals infected with Human Immunodeficiency Virus (HIV) and/or co-infected with Hepatitis C Virus (HCV) and to compare this with the counts in normal individuals in The Gambia. Methods: Blood samples were taken from 1500 individuals referred for HIV serology at the Royal Victoria Teaching Hospital (RVTH) following informed consent. Samples were tested for antibodies to HIV by the Murex ELISA, antibodies to HCV by the Ortho ELISA, and CD4 counts determined by the Dynalimmunomagnetic cell isolation method Results: Of the 1500 patients screened for HIV and HCV antibodies, 6.7% (101/1500) were infected with HIV, 0.6 % (9/ 1500) were co-infected with HCV and 1.5 %( 22/1500) were infected with HCV alone. Almost half (44.6%; 25/56) of HIV- 1 infected patients had a CD4+ lymphocyte count at diagnosis of 200 cells/µl or less as compared to 41.7 %( 10/24) of HIV-2 and 75% (6/8) of HIV-D infected patients. The rate of CD4 decline was higher among HIV/ HCV co-infected persons than individuals infected with HIV or HCV. The rate of decline was higher among men than women. These differences did not reach statistical significance due in large part to the small number of participants who completed the programme. The CD4+ lymphocyte count of apparently healthy Gambian male and females was 489 cells/µl and 496 cells/ µl respectively. This rate is lower than that reported for Caucasians, but in agreement with the global range. Conclusion: A significant progressive decline in CD4+ lymphocyte count was observed among the female control group who were negative for HIV and HCV. This finding is unclear and calls for a longitudinal study involving a cohort of women in this region. Short title: CD4+ counts in HIV/HCV co-infection.