The Impact of Cirrhosis on CD4+ T Cell Counts in HIV-Seronegative Patients

• Published in: Clinical infectious diseases 2007-02, Vol.44 (3), p.431-437
• Main Authors: McGovern, Barbara H., Golan, Yoav, Lopez, Marvin, Pratt, Daniel, Lawton, Angela, Moore, Grayson, Epstein, Mark, Knox, Tamsin A.
• Format: Article
• Language: English
• Subjects: Adult; AIDS; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes - cytology; CD4-Positive T-Lymphocytes - physiology; Cells; Cirrhosis; Cross-Sectional Studies; Cytometry; Etiology; Female; HIV; HIV infections; HIV/AIDS; Human immunodeficiency virus; Humans; Hypertension, Portal - complications; Hypertension, Portal - immunology; Infectious diseases; Leukocyte Count; Liver; Liver cirrhosis; Liver Cirrhosis - blood; Liver Cirrhosis - immunology; Liver diseases; Lymphocytes; Male; Middle Aged; Prospective Studies; Reproducibility of Results; Severity of Illness Index; Splenomegaly - blood; Studies; T lymphocytes
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/509580

Background.Studies of the progression liver fibrosis in human immunodeficiency virus (HIV) and hepatitis C virus-coinfected patients suggest that cirrhosis is associated with immunosuppression, as measured by low absolute CD4+ T cell counts. However, we hypothesized that, in patients with advanced liver disease, low CD4+ T cell counts may occur secondary to portal hypertension and splenic sequestration, regardless of the presence or absence of HIV infection. Methods.Sixty HIV-seronegative outpatients with cirrhosis were enrolled during the period 2001–2003 in a prospective, cross-sectional study of the association between liver disease and CD4+ T cell counts and percentages. Demographic characteristics, liver disease-related characteristics, and laboratory results—including CD4+ T cell parameters—were collected. Results.A total of 39 patients (65%) had a low CD4+ T cell count; 26 patients (43%) and 4 patients (7%) had CD4+ T cell counts