Department of Infectious Diseases, Odense University Hospital, University of Southern Denmark, Odense C, Denmark.
BMC Infect Dis. 2012 Mar 21;12:66. doi: 10.1186/1471-2334-12-66.
The interaction of HIV and tuberculosis (TB) on CD4 levels over time is complex and has been divergently reported.
CD4 counts were assessed from time of diagnosis till the end of TB treatment in a cohort of pulmonary TB patients with and without HIV co-infection and compared with cross-sectional data on age- and sex-matched non-TB controls from the same area.
Of 1,605 study participants, 1,250 were PTB patients and 355 were non-TB controls. At baseline, HIV was associated with 246 (95% CI: 203; 279) cells per μL lower CD4 counts. All PTB patients had 100 cells per μL lower CD4 counts than the healthy controls. The CD4 levels were largely unchanged during a five-month of TB treatment. HIV infected patients not receiving ART at any time and those already on ART at baseline had no increase in CD4 counts after 5 months of TB treatment, whereas those prescribed ART between baseline and 2 months, and between 2 and 5 months increased by 69 (22;117) and 110 (52; 168) CD4 cells per μL after 5 months.
The increase in circulating CD4 levels observed in PTB in patients is acquired after 2 months of treatment irrespective of HIV status. Initiation of ART is the strongest factor correlated with CD4 increase during TB treatment.
Clinical trials.gov: NCT00311298.
HIV 和结核病（TB）对 CD4 水平的相互作用随着时间的推移是复杂的，并有不同的报道。
在一组合并 HIV 感染和未合并 HIV 感染的肺结核（PTB）患者中，从诊断时起至 TB 治疗结束时评估 CD4 计数，并与同一地区年龄和性别匹配的非 TB 对照的横断面数据进行比较。
在 1605 名研究参与者中，1250 名是 PTB 患者，355 名是非 TB 对照。在基线时，HIV 与每微升 CD4 计数低 246（95%CI：203；279）个细胞相关。所有 PTB 患者的 CD4 计数比健康对照组低 100 个细胞。在五个月的 TB 治疗期间，CD4 水平基本不变。在任何时候都没有接受 ART 的 HIV 感染患者和基线时已经接受 ART 的患者在五个月的 TB 治疗后 CD4 计数没有增加，而那些在基线和两个月之间以及在两个月和五个月之间开始接受 ART 的患者在五个月后 CD4 计数分别增加了 69（22；117）和 110（52；168）个细胞。
PTB 患者在治疗两个月后观察到循环 CD4 水平的增加是获得性的，与 HIV 状态无关。ART 的启动是与 TB 治疗期间 CD4 增加最相关的因素。
ClinicalTrials.gov：NCT00311298。
