Comparative Assessment of Neutrophil Counts and use of Neutropenia to predict Low CD4 Count in Anti-Retroviral Therapy (Art)-Naive HIV positive Children in Enugu, Nigeria

Abstract

BACKGROUND: Neutropenia has been noted to be associated with HIV disease progression and reduced survival in children. Neutropenia has been postulated to be associated with low CD4 count in HIV-positive children by some researchers. Hence, this study sought to assess the prevalence of neutropenia in ART-naïve HIV-positive patients and compare them to HIV-negative subjects and also to investigate if reduced absolute neutrophil counts can be used to predict low CD4 count in the HIV-positive patients. 

METHODS: This study was a prospective observational study carried out at the University of Nigeria Teaching Hospital, Enugu, involving a total of 200 children (100 test subjects and 100 test controls). Biodata was collected with a proforma and blood samples were subsequently collected and analysed for neutrophil count and CD4 count. Data generated were analysed with Statistical Package for Social Sciences (SPSS) version 22.

RESULTS: The result showed that neutropenia with a prevalence of 18% is not significantly associated with HIV infections. It was also shown that there is no significant association between the age of the children and neutropenia. Likewise, CD4 count was not significantly associated with neutropenia.

CONCLUSION: The study showed that neutropenia in the subjects is comparable with that of the controls and cannot be used as a substitute for CD4 count or as one of the criteria for commencement of antiretroviral medications in ART-naive HIV-positive children.