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Reference Values of CD4 T Lymphocytes in Human Immunodeficiency Virus-Negative Adult Nigerians

Olumuyiwa Aina,^1, Jelpe Dadik,^2, Manhattan Charurat,¹ Patience Amangaman,² Silas Gurumdi,² Edwina Mang,² Ruth Guyit,³ Ndam Lar,² Pam Datong,² Comfort Daniyam,² Phyllis Kanki,⁴ Alash'le Abimiku,^1* for the Institute of Human Virology/Plateau State Specialist Hospital AIDS Prevention in Nigeria Study Team,

Division of Epidemiology and Prevention, Institute of Human Virology, Baltimore, Maryland,¹ Plateau State Specialist Hospital (PSSH), Jos, Plateau State, Nigeria,² Institute of Education, University of Jos, Jos, Plateau State, Nigeria,³ School of Public Health, Harvard University, Boston, Massachusetts⁴

Received 9 November 2004/ Returned for modification 12 January 2005/ Accepted 14 February 2005

A cross-sectional study that involved secondary analysis of data collected from 681 pregnant women and 183 miners (94 men and 89 women; ratio of men to women, 1:0.95) in Jos, Nigeria, was carried out to determine the reference ranges for CD4⁺-cell counts in healthy HIV-negative adult Nigerians. The main results of interest were CD4⁺-cell counts and odds ratios (ORs) of low CD4⁺-cell counts, defined as below 350 cells per µl. CD4⁺-cell counts were similar in men and nonpregnant women, with a mean (standard deviation) of 828 (203) cells per µl, but pregnant women had a lower value of 771 (250) cells per µl. None of the factors assessed was related to the odds of having a low CD4⁺-cell count among men and nonpregnant women, but age, age of marriage, and alcohol usage were significant predictors in pregnant women. Compared to pregnant women less than 20 years old, older women had significantly lower odds of a low CD4⁺-cell count (ORs were 0.06 for women aged 20 to 29 years and 0.22 for those aged 30 to 39 years). When compared with those pregnant women who were married before 20 years of age, those who married at 20 to 29 years and 30 to 39 years had odds ratios of 6.41 and 9.40, respectively. Previous alcohol use was also associated with low CD4⁺-cell counts (OR, 5.15). The 95% confidence interval for CD4⁺-cell counts in healthy adult Nigerians is 547 to 1,327 cells per µl, and this is the first time this has been determined.

First coauthors.

Investigators in the AIDS Prevention Initiative in Nigeria are listed in Acknowledgments.