Immune Dysfunction in HIV infected stroke patients: Role of low CD4 counts

Whether or not low CD4 count directly contributes to stroke among HIV infected stroke patients is yet to be elucidated. This study aimed to ascertain the role of low CD4 count in the pathophysiology of stroke in HIV infection. This was a hospital-based, case-control study. Sixty five (65) consecutive stroke patients (36 males and 29 females) aged 20-68 years and sixty five (65) age-and-sex matched controls were enrolled. A structured questionnaire was administered. Neurological examination was performed and computed tomography scan of the brain done. Blood samples were taken for HIV 1&2 screening using ELISA method. Positive test using two different kits constituted a positive result. CD4 count was determined by western blot method. The mean CD4 count of HIV positive stroke patients (224.92 cells/cm3) is significantly lower (P <0.001) than that of HIV negative patients (690.67 cells/cm3). Nine out of thirteen (9/13, 69%) HIV positive stroke patients have CD4 <200 cells/μl. In addition to the conventional risk factors for ischemic stroke in HIV-infected patients, immune dysfunction (low CD4 count) is an important and significant modifiable risk factor of ischemic stroke event among HIV infected adult population of Northeastern Nigeria. Consequently, better understanding and awareness of the role of low CD4 count in the pathogenesis of stroke among HIV adults in this environment may provide a roadmap for controlling one of the deleterious non-opportunistic neurologic complication of HIV infectionKeywords: CD4 count, HIV, Immune Dysfunction, Strok