Khan Nawaid Hussain, Verma Chaitenya, Beg Mirza Masroor Ali, Kumar Shashi Nandar, Kaushik Gaurav, Ahmad Hafiz, Osmonaliev Kudaibergen, Kumar Vinay
Faculty of Medicine, Ala-Too International University, Bishkek, Kyrgyz Republic.
All India Institute of Medical Sciences, New Delhi, 110029, India.
Immunotargets Ther. 2024 Dec 10;13:691-705. doi: 10.2147/ITT.S495295. eCollection 2024.
CD4+ cells, HIV-1 plasma viral load (PVL), and IFN-γ have been observed to enhance susceptibility in TB infection/reactivation among HIV-1 infected people, leading to unusual clinical manifestations. HIV-TB co-infection is significant for immunological and virological response, making it a great clinical challenge for patient management. The objective of this study was to explore the correlation among various hematological and biochemical profiles with CD4+ count and PVL in order to decipher mechanisms of TB development or reactivation in HIV-infected patients.
In this cross-sectional study, we included 200 newly diagnosed treatment naïve HIV-1 infected patients, of which 118 were HIV-TB co-infected and 82 were HIV-alone. The CD4+ T count was determined using the BD FACS Count System, and the plasma HIV-1 viral load was estimated using the Abbott m2000 real-time platform. The hematobiochemical testing was performed on fully-automated analyzer ADVIA 560 and Cobas 501 Roche Diagnostics. Statistical software SPSS-2, Spearman correlation analysis was used for data analysis and a P-value less than 0.05 was considered statistically significant.
Declined hemoglobulin level positively correlated with CD4 counts (r = 0.229; p = 0.001), and a negative correlation was observed with HIV-1 plasma viral load (r = -0.171; p = 0.016). Moreover, the CD4+ count and HIV-1 plasma viral load (PVL) were also correlated to anomalies such as thrombocytopenia, leucopenia, eosinophils, neutrophils, ESR, potassium, Albumin, globulin, SGOT, uric acid. Studies also found significantly higher absolute neutrophil count, ESR, and serum fasting blood sugar, creatine, uric acid, total bilirubin, globulin, and alkaline phosphatase in HIV-TB co-infected patients.
The initial value of Hb, ESR, absolute neutrophil counts, serum calcium, uric acid, and potassium can be used as an early indicator for active tuberculosis (TB) and as a substitute marker for the course of HIV disease, especially in areas with low resources.
已观察到CD4+细胞、HIV-1血浆病毒载量（PVL）和IFN-γ会增加HIV-1感染者发生结核感染/复发的易感性，导致出现不寻常的临床表现。HIV-TB合并感染对免疫和病毒学反应具有重要意义，给患者管理带来了巨大的临床挑战。本研究的目的是探讨各种血液学和生化指标与CD4+计数及PVL之间的相关性，以阐明HIV感染患者结核病发生或复发的机制。
在这项横断面研究中，我们纳入了200例新诊断的未接受过治疗的HIV-1感染者，其中118例为HIV-TB合并感染，82例为单纯HIV感染。使用BD FACS Count系统测定CD4+T细胞计数，使用雅培m2000实时平台估计血浆HIV-1病毒载量。在全自动分析仪ADVIA 560和罗氏诊断公司的Cobas 501上进行血液生化检测。使用统计软件SPSS-2，采用Spearman相关性分析进行数据分析，P值小于0.05被认为具有统计学意义。
血红蛋白水平下降与CD4计数呈正相关（r = 0.229；p = 0.001），与HIV-1血浆病毒载量呈负相关（r = -0.171；p = 0.016）。此外，CD4+计数和HIV-1血浆病毒载量（PVL）还与血小板减少、白细胞减少、嗜酸性粒细胞、中性粒细胞、血沉、钾、白蛋白、球蛋白、谷草转氨酶、尿酸等异常情况相关。研究还发现，HIV-TB合并感染患者的绝对中性粒细胞计数、血沉以及血清空腹血糖、肌酐、尿酸、总胆红素、球蛋白和碱性磷酸酶显著更高。
血红蛋白、血沉、绝对中性粒细胞计数、血清钙、尿酸和钾的初始值可作为活动性结核病（TB）的早期指标以及HIV疾病进程的替代标志物，尤其是在资源匮乏地区。
