Comparison of CD4 Cell Counts in Pregnant HIV-Seropositive and HIV-Seronegative Nigerian Women

Abstract

Objective: To evaluate the CD4 cell count of human immunodeficiency virus (HIV)-positive pregnant ethnic Nigerian women and compare it with that of HIV-negative pregnant ethnic Nigerian women and to determine the relationship between CD4 cell count and the packed red blood cell volume (PCV) of HIV-seropositive and HIV-seronegative pregnant women. Materials/Methods: The study population included 130 ethnic Nigerian women between the ages of 17 and 40 years who came to the Antenatal and Prevention of Mother-to-Child Transmission (PMTCT) units of Jos University Teaching Hospital, in Jos, Nigeria. Relevant information such as age, occupation, tribal affiliation, gestational age, and prescribed drugs currently taken were obtained using a structured questionnaire. A selective technique was used to enroll pregnant women who tested positive for HIV infection and negative for malaria parasitemia, syphilis, and hepatitis B virus, along with healthy pregnant women with no history of these diseases. CD4 cell counts were determined using a Cyflow machine and packed red blood cell volume (PCV) obtained using a microhematocrit centrifuge. The Student t-distribution t-test was used to analyze data. Results: The highest prevalence of HIV infection was found in the group aged 26 to 30 years; the lowest prevalence was found in the group aged 36 to 40 years. The mean (SD) CD4 cell counts of HIVseropositive and seronegative women were 323.7 (170.7) and 578.3 (167.4), respectively (P < .001). Comparison of the CD4 cell count of HIV-positive and HIV-negative pregnant women with the PCV values from specimens from those women demonstrated a correlation coefficient r of 0.37 (P < .001) for the former group and an r of 0.37 (P < .82) for the latter. In HIV-seropositive and HIV-seronegative pregnant women with gestational age of less than 13 weeks, the mean (SD) CD4 cell counts were 610.X (170.3) (P < .001) and 302.0 (49.0) (P < .001) for the former and latter groups, respectively. The mean CD4 cell counts of the HIV-positive and HIV-negative pregnant women enrolled in our study with gestational age of 13 to 25 weeks and 26 to 38 weeks were 596 (146) (P < .001), 304 (170) (P < .001), 534 (189) (P < .001), and 254 (191) (P <.003), respectively. Conclusions: This study suggests that pregnancy may partially deplete CD4 cells because a significant difference was observed in mean (SD) CD4 cell count in HIV-seropositive and HIV-seronegative pregnant women at various gestational ages. Chronological age did not affect the mean CD4 cell count if there was no accompanying disease condition. We also conclude that PCV in HIV-seropositive pregnant women was directly proportional to their CD4 cell counts.