Factors influencing CD4+ T cell counts in people living with HIV with end-stage kidney disease

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dc.contributor.authorPretorius, Melanie
dc.date.accessioned2021-10-12T13:18:43Z
dc.date.available2021-10-12T13:18:43Z
dc.date.issued2020
dc.descriptionA research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine (Haematology) to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2020en_ZA
dc.description.abstractIntroduction: In South Africa, it is estimated that ~7 million people are living with Human Immunodeficiency Virus (HIV). HIV is associated with an increased risk of kidney disease. For people living with HIV (PLWH) who develop end-stage kidney disease (ESKD), access to renal replacement therapy can be difficult. Kidney transplantation is a cost-effective option, with improved overall survival and better quality of life. Eligibility criteria for kidney transplantation in Johannesburg includes a sustained CD4+ T cell count of >200 cells/μl and suppressed HIV replication. This study aimed to investigate the influence of hemodialysis on the lymphocyte subsets in PLWH with ESKD. Methods: Study participants and controls were recruited from renal dialysis centres in Johannesburg. Demographic data, social data, serial CD4+ T cell counts, serial HIV viral load measurements and blood samples were collected (before and after a haemodialysis session). Lymphocyte subsets were then measured. Results: Our cohort showed a statistically significant increase in the post-dialysis % of CD4+ T cells and the absolute CD4+ T cell counts. The longitudinal trend analysis for the % of CD4+ T cells revealed a significant increase in five participants and a single patient had a significant decrease in the longitudinal trend analysis for the absolute CD4+ T cell counts. The longitudinal trend analysis for HIV viral load revealed the majority of our participants were not virologically suppressed. Conclusion: This study showed that haemodialysis does not negatively impact CD4+ T cell count, suggesting that immunologic recovery is not impeded by treatment of the underlying ESKD.en_ZA
dc.description.librarianTL (2021)en_ZA
dc.facultyFaculty of Health Sciencesen_ZA
dc.identifier.urihttps://hdl.handle.net/10539/31675
dc.language.isoenen_ZA
dc.schoolSchool of Pathologyen_ZA
dc.titleFactors influencing CD4+ T cell counts in people living with HIV with end-stage kidney diseaseen_ZA
dc.typeThesisen_ZA
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