Analysis of cluster of differentiation 4 cell counts with clinical stages and opportunistic infection in patients with human immunodeficiency virus-acquired immunodeficiency syndrome

BACKGROUND: The human immunodeficiency virus (HIV) attacks the host's immune system, specifically white blood cells expressing cluster of differentiation 4 (CD4). The CD4 cell count is a blood test used to assess a patient's immune status and risk of developing opportunistic infections (OIs) to guide diagnosis and therapy. This study evaluated the cor-relations between CD4 cell counts and clinical stage in patients with HIV-acquired immunodeficiency syndrome (AIDS), with or without OI.METHODS: This study was conducted at Dr. Wahidin Sudirohusodo Hospital between January 2019 and December 2021. Patients' age, sex, risk factors, clinical staging based on the World Health Organization 2015 criteria, and CD4 cell count were recorded. Data were analyzed using Kolmogorov-Smirnov Test, Mann-Whitney Test, Kruskal-Wallis Test, and Spearman's rank correlation (r(s)) test. All results with P<0.05 were considered statistically significant.RESULTS: This study included 358 samples aged 19-87 years, of which most were male (72.1%), in stage IV (48.9%), and had OIs (66.8%). The most prevalent risk factor was a heterosexual relationship (50.8%). The median CD4 cell count was 107.5 cells/L. CD4 cell counts differed significantly between clinical HIV-AIDS stages (P<0.05) and were sig-nificantly negatively correlated with the parameters (r(s)=0.897, P<0.001). Median CD4 cell counts differed significantly between patients with (47 cells/mu L) and without (273 cells/mu L) OIs (P<0.05). Moreover, CD4 cell counts were negatively correlated with OIs (r(s)=0.764, P<0.05).CONCLUSIONS: CD4 cell counts can aid diagnosis and treatment decisions patients with HIV-AIDS.