Correlation of CD4 counts with the FNAC patterns of tubercular lymphadenitis in patients with HIV: A cross sectional pilot study

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Abstract

Background:

Fine needle aspiration cytology (FNAC) of TB lymphadenitis (TBL) in HIV shows four different patterns, which may be reflective of immune status. We hypothesize that the CD4 counts, a marker of immunologic status, correlates with FNAC morphology of TBL. This study was undertaken to compare the mean CD4 counts across the different cytology patterns and to correlate the CD4 counts with FNAC patterns in these patients.

Methods:

Forty newly diagnosed HIV patients with TBL on FNAC (10 in each pattern) were selected by convenient sampling based on inclusion exclusion criteria. The CD4 counts were obtained in these patients. Its correlation with different FNAC patterns was assessed using SPSS version 16.

Results:

Analysis of covariance showed significant difference in the mean CD4 counts between all the four patterns [F (374), df (3), P-value = 0.000]. Spearman's correlation analysis showed significant correlation of CD4 counts with the FNAC patterns (correlation coefficient of 0.967; P-value of 0.01) with pattern 1 having low CD4 counts and pattern 4 having high CD4 counts.

Conclusion:

CD4 counts show significant correlation with FNAC patterns of TBL in HIV patients. Pattern 1, suggestive of poor immunological response (chiefly necrosis, occasional ill defined granuloma, AFB 3+) had low CD4 counts, while pattern 4, suggestive of good immunological response (well defined granuloma, no necrosis and AFB 1+), had high CD4 counts. Thus FNAC patterns may be used to predict the CD4 counts in HIV patients where CD4 facilities are not available or vice versa. Diagn. Cytopathol. 2015;43:16–20. © 2014 Wiley Periodicals, Inc.

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