Human Immunodeficiency Virus and Immunological Profiles among Suspected Tuberculosis Cases in Mombasa County, Kenya

Abstract

Background: Human immunodeficiency virus (HIV) is a major public health concern and cause of death globally including Kenya. HIV infection is characterised by CD4+ lymphocyte depletion manifested through the loss of the immune response capacity. Aim: This study aimed to determine the prevalence of HIV infection and CD4+T cell counts among suspected tuberculosis (TB) cases seeking healthcare at TB clinics in Mombasa County, Kenya. Study Design: Hospital and laboratory based cross-sectional study was carried between May 2011 and November 2013 in Coast General Referral Hospital, Tudor, Port-Reitz, Mlaleo, Likoni and Mikandani districts and sub-districts hospitals. Methodology: A total of 500 suspected TB cases (271 males and 229 females) were screened for HIV infection using Trinity Biotech Uni-Gold™ test and positives confirmed with the enzyme-linked immunosorbent assay. CD4+ and CD8+T cells were analyzed using a BD FACS Count flow cytometer. A questionnaire was used to collect demographic data of the participants. Results: In total, 127 (25.4%) of the suspects were HIV infected 55.1% females and 44.9% males. Females were significantly affected than males (OR = 0.78; 95% CI: 0.44 - 1.37; p = 0.042). The majority (36.2%) of the HIV cases were in the 25 - 34 years age group followed by the 35 - 44 (33.9%), 45 - 54 (16.5%) and 18 - 24 (7.1%) age groups, respectively. Widowed (AOR = 6.14; 95% CI: 1.53 - 20.54; p < 0.033), alcohol (AOR = 2.83; 95% CI: 1.71 - 4.87; p < 0.001) and condom use (AOR = 2.31; 95% CI: 1.62 = 4.71; p < 0.002) were risk factors associated with HIV infection. The mean CD4 cell count was 333.27 ± 150.59 cells/mm3 and it was higher in males (343.05 ± 149.33 cells/mm3) than females (325.93 ± 152.92 cells). The mean values of white blood cells (5.9 ± 2.42) × 109/l), packed cell value (34.1% ± 4.3%), platelets (195.16 ± 88.7) × 109/l and erythrocyte sedimentation rate (102.0 ± 17.4 mm/hr) were significantly lower than the control group (p < 0.05). Conclusion: The prevalence of HIV infection among suspected TB cases was 25.4% which was higher than the current national average HIV prevalence of 6.9%. Lower CD4+ lymphocyte count was found to be the only predicting factor for HIV. There was a significant relationship between CD4/ESR and HIV infection.