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Indian Journal of Medical Microbiology, Vol. 28, No. 1, January-March, 2010, pp. 79-80 Correspondence CD4+ T lymphocyte count in healthy HIV seronegative adults of north India *N Jindal, U Arora Department of Microbiology (NJ, UA), Government Medical College, Amritsar - 143 001, India Correspondence Address: *Department of Microbiology, Government Medical College, Amritsar - 143 001, India, neerjarajender@hotmail.com Date of Submission: 06-Dec-2008 Code Number: mb10024 PMID: 20061776 DOI: 10.4103/0255-0857.58741 Dear Editor, Apropos the correspondence regarding CD4 and CD8 reference counts in normal healthy South Indian adults and the importance to have similar data from different geographical areas and ethnic groups of our country, [1] we present the baseline data of CD4 + T lymphocyte count among the normal healthy population of North India (Amritsar-Punjab) from where this information is lacking. A total of 70 apparently healthy HIV seronegative medical students, residents and health care workers of both the sexes (Male 45, Female 25) between the age of 20-35 years were studied over a period of 22 months (September 2006 to June 2008) in the ICTC (Integrated Counseling and Training Center) of Microbiology Department. Exclusion criteria were included: a) Any minor illness during the past one month b) Any major illness/surgery during the past six months c) Any chronic illness d) Vaccination within past six months e) Pregnancy f) Active drug abuse. All the individuals were first screened for HIV antibodies by ELISA tests (Microelisa HIV J. Mitra and Co Pvt Ltd) after obtaining their informed written consent. For CD4 + T lymphocyte enumeration, 2 ml of blood was collected between 8 AM to 11 AM in vacuitainers with EDTA. CD4 + T lymphocyte counts were determined by Flow Cytometry which is considered as a gold standard 2 . BD FACSCount TM CD4/CD3 reagents and FACSCount controls of BD BioSciences Becton Dickinson-San Jose,CA were used to perform all the tests according to the manufacturer's instructions. Data was subjected to Microsoft-Excel for the value of mean and standard deviation and Chi-square test to compare the counts in different groups. The study was carried out after obtaining ethical clearance from the ethical clearance body of our institute. The mean CD4 + T lymphocyte count in the present study was 768.5 ± 142.1/μl. It was 720.2 ± 66.2/μl in males and 856.4 ± 187.3/μl in females. The range was 327 to 1272 in males and 580 to 1303 in females. Reference value for CD4 + T count among Indians have been reported but the information is based upon a relatively small number of blood samples generally confined to some geographical areas. [2] Reports from South India document CD4 counts of 1048/μl (n = 46),799/μl (n = 21) and 834.7/ μl (n = 30) in different studies. [1],[3],[4] In North East the count observed was 848 + 395/μl (n = 14) [5] and in North West it was763.81/ μl (n = 65) [2] The mean reference count of the present study North India (768.5 ± 142.1/μl) is close to that of North West [2] and one of the studies from South India. [1] Significantly higher counts observed in females than in males [ P = 0.018] of the present study are also similar to the findings of North West study [2] and could be because of the influence of sex hormones on lymphocyte sub populations. However, in our series, CD4 count was < 500/ μl in only 4.3% (3/70) normal individuals which is much less than that reported from South (10.6%) [4] and North west India (20%). [2] It can thus be concluded that there is heterogenicity in baseline CD4 + T lymphocyte count of healthy normal Indian adults. Large scale studies conducted in different geographical areas are needed to have our own reference values which would help in thorough assessment and management of our HIV infected patients. References
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