Immune Dysfunction in HIV infected stroke patients: Role of low CD4 counts

Abstract

Whether or not low CD₄ count directly contributes to stroke among HIV infected stroke patients is yet to be elucidated. This study aimed to ascertain the role of low CD₄ count in the pathophysiology of stroke in HIV infection. This was a hospital-based, case-control study. Sixty five (65) consecutive stroke patients (36 males and 29 females) aged 20-68 years and sixty five (65) age-and-sex matched controls were enrolled. A structured questionnaire was administered. Neurological examination was performed and computed tomography scan of the brain done. Blood samples were taken for HIV 1&2 screening using ELISA method. Positive test using two different kits constituted a positive result. CD₄ count was determined by western blot method. The mean CD₄ count of HIV positive stroke patients (224.92 cells/cm³) is significantly lower (P <0.001) than that of HIV negative patients (690.67 cells/cm³). Nine out of thirteen (9/13, 69%) HIV positive stroke patients have CD4 <200 cells/μl. In addition to the conventional risk factors for ischemic stroke in HIV-infected patients, immune dysfunction (low CD₄ count) is an important and significant modifiable risk factor of ischemic stroke event among HIV infected adult population of Northeastern Nigeria. Consequently, better understanding and awareness of the role of low CD₄ count in the pathogenesis of stroke among HIV adults in this environment may provide a roadmap for controlling one of the deleterious non-opportunistic neurologic complication of HIV infection

Keywords: CD₄ count, HIV, Immune Dysfunction, Stroke