Skip to content
2000
  1. Home
  2. A-Z Publications
  3. Current HIV Research
  4. Fast Track Articles
  5. Fast Track Article
image of Correlation of Total Lymphocyte Count, Human Immunodeficiency Virus Infection Status, and Tuberculosis Lesions on Chest X-ray: Can TLC Be an Alternative to CD4?

Abstract

Background

Tuberculosis (TB), caused by Mycobacterium tuberculosis, often becomes a comorbidity in individuals infected with Human Immunodeficiency Virus (HIV), the cause of Acquired Immunodeficiency Syndrome (AIDS). HIV-positive individuals have a 30-fold higher risk of contracting TB compared to non-HIV individuals. Assessment of HIV-TB disease progression commonly relies on measuring CD4 cell counts. However, in areas with limited access, the World Health Organization (WHO) recommends using Total Lymphocyte Count (TLC) ≤ 1200 cells/μL as an alternative. Additionally, chest X-rays, a widely accessible radiological method, aid in diagnosing TB in HIV-positive patients, complementing TLC in assessing disease progression in limited facilities.

Objective

The objective of this study was to analyze the differences in the location and characteristics of TB lesions based on HIV status and TLC levels.

Methods

A case-control study was conducted at Adam Malik Central Hospital on pulmonary TB patients from December 2021 to December 2022, meeting inclusion criteria. Evaluation of TB lesion locations and characteristics was performed by two researchers, while HIV status and TLC data were extracted from medical records.

Results

The study involved 154 subjects, including 77 HIV-positive and 77 non-HIV individuals. The percentage of male participants was 81.8%, with a mean age of 43.4 ± 14.4 years. The significant differences in the characteristics and locations of lesions (cavities, miliary lesions, fibrosis, atelectasis, and upper and lower lung) were revealed in HIV-positive and HIV-negative patients. Similarly, significant differences in the characteristics and locations of lesions (cavities, miliary lesions, fibrosis, atelectasis, and upper and lower lung) were revealed in a patient with TLC ≤ 1200 and TLC > 1200.

Conclusion

The study highlights significant differences in the characteristics and locations of tuberculosis lesions about HIV status and total lymphocyte count levels among pulmonary TB patients. HIV-positive individuals exhibited distinct patterns of TB lesions compared to their HIV-negative counterparts, indicating the impact of HIV on TB disease progression. Furthermore, variations in lesion characteristics were also observed based on TLC levels, with notable differences between patients with TLC ≤ 1200 cells/μL and those with TLC > 1200 cells/μL. These findings underscore the importance of considering both HIV status and TLC in the assessment and management of TB in affected individuals. TLC can serve as an alternative to CD4 measurement in situations where access to CD4 testing is limited.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/chr/10.2174/011570162X330293250206093453
2025-02-14
2025-04-23

  • From This Site

    /content/journals/chr/10.2174/011570162X330293250206093453
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. National Guidelines for Medical Services for the Management of Tuberculosis. Ministry of Health of the Republic of Indonesia. 2020 Available from: https://tbindonesia.or.id/download/9840/?tmstv=1697763572
  2. Longo D.L. Fauci A.S. The human retroviruses. Harrison’s Principles of Internal Medicine. 20th ed Loscalzo J. Fauci A.S. Kasper D.L. Hauser S.L. Longo D.L. Jameson J.L. New York McGraw-Hill 2022 1521 1527
    [Google Scholar]
  3. Kon O.M. Tuberculosis in Clinical Practice. Cham, Switzerland Springer 2021 10.1007/978‑3‑030‑75509‑6
    [Google Scholar]
  4. Global tuberculosis report 2021. 2021 Available from: https://www.who.int/publications/i/item/9789240037021
  5. Health Profile of North Sumatra Province 2019. Medan North Sumatra Provincial Health Office 2020
    [Google Scholar]
  6. Sereti I. Bisson G.P. Meintjes G. HIV and Tuberculosis: A formidable alliance. Cham Springer 2022
    [Google Scholar]
  7. Ministry of health directorate general of disease prevention and control. 2019 Available from: https://siha.kemkes.go.id/portal/files_upload/buku_petunjukFINAL.pdf
  8. World Health Organization Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach. 2013 Available from: https://www.who.int/publications/i/item/9789241549684
  9. Qinthara MH Sidipratomo P Bustamam N Comparison of chest x-ray lesion locations in pulmonary tuberculosis patients with and without hiv infection. Medika Kartika J. Med. Health 2021 4 5 471 482 10.35990/mk.v4n5.p471‑482
    [Google Scholar]
  10. Peer V. Schwartz N. Green M.S. Gender differences in tuberculosis incidence rates—A pooled analysis of data from seven high-income countries by age group and time period. Front. Public Health 2023 10 997025 10.3389/fpubh.2022.997025 36703824
    [Google Scholar]
  11. Liu H. Zhang X.G. Huang X.L. Dynamic observation and analysis of T lymphocyte subpopulations in patients with active pulmonary tuberculosis in different age groups. J Hebei Med Univ 2016 37 08 889 892
    [Google Scholar]
  12. Kisembo H.N. Boon S.D. Davis J.L. Okello R. Worodria W. Cattamanchi A. Huang L. Kawooya M.G. Chest radiographic findings of pulmonary tuberculosis in severely immunocompromised patients with the human immunodeficiency virus. Br. J. Radiol. 2012 85 1014 e130 e139 10.1259/bjr/70704099 21976629
    [Google Scholar]
  13. Padyana M. Bhat R. Dinesha M. Nawaz A. HIV-tuberculosis: A study of chest X-ray patterns in relation to CD4 count. N. Am. J. Med. Sci. 2012 4 5 221 225 10.4103/1947‑2714.95904 22655281
    [Google Scholar]
  14. Affusim C. Abah V. Kesieme E.B. Anyanwu K. Salami T.A.T. Eifediyi R. The effect of low CD4+ lymphocyte count on the radiographic patterns of HIV patients with pulmonary tuberculosis among Nigerians. Tuberc. Res. Treat. 2013 2013 1 4 10.1155/2013/535769 23431432
    [Google Scholar]
  15. Wuan A.O. Herlinalt Gloria Banunu A. Kambuno N.T. Total lymfosit count (TLC) with CD4 in HIV/AIDS patients at Kupang. J Lab Technol. 2019 8 2 70 75 10.29238/teknolabjournal.v8i2.189
    [Google Scholar]
/content/journals/chr/10.2174/011570162X330293250206093453
Loading
Correlation of Total Lymphocyte Count, Human Immunodeficiency Virus Infection Status, and Tuberculosis Lesions on Chest X-ray: Can TLC Be an Alternative to CD4?
Bentham Science Publishers ; https://doi.org/10.2174/011570162X330293250206093453
/content/journals/chr/10.2174/011570162X330293250206093453
/content/journals/chr/10.2174/011570162X330293250206093453
Loading

Data & Media loading...


  • Article Type:     Research Article
Keywords: AIDS ; CD4 ; tuberculosis ; HIV ; TLC ; chest X-ray

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test