Age, sex, and nutritional status modify the CD4+ T-cell recovery rate in HIV–tuberculosis co-infected patients on combination antiretroviral therapy

Abstract

Background: Baseline age and combination antiretroviral therapy (cART) were examined as determinants of CD4+ T-cell recovery during 6 months of tuberculosis (TB) therapy with/without cART. It was determined whether this association was modified by patient sex and nutritional status. Methods: This longitudinal analysis included 208 immune-competent, non-pregnant, ART-naive HIV-positive patients from Uganda with a first episode of pulmonary TB. CD4+ T-cell counts were measured using flow cytometry. Age was defined as ≤24, 25–29, 30–34, and 35–39 vs. ≥40 years. Nutritional status was defined as normal (>18.5 kg/m2) vs. underweight (≤18.5 kg/m2) using the body mass index (BMI). Multivariate random effects linear mixed models were fitted to estimate differences in CD4+ T-cell recovery in relation to specified determinants. Results: cART was associated with a monthly rise of 15.7 cells/μl (p 18.5 kg/m2 or they are female. These patients may benefit from increased monitoring and nutritional support during cART.

Keywords

• HIV
• Nutritional status
• Immune-competence
• Aging
• HAART