Establishment of CD4 and CD8 Lymphocyte subsets in a healthy HIV and Toxoplasma seronegative pregnant women in Libya
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Most of the diagnostic laboratories in Libya often depend on western textbooks for CD4+- and CD8+ T-lymphocyte reference values. In this paper, we established reference ranges for the Libyan Toxoplasma, HIV, HBV, and HCV seronegative healthy pregnant women in all trimesters of pregnancy, and compared them with a control group of non-pregnant women. Whole-blood samples were collected to provide normal ranges for CD4+ and CD8+ Lymphocyte subsets expressed as mean ± standard division. A total of 110 Libyan women who came from Tripoli and Zwara districts were investigated; 70 pregnant women (aged 27.8 ± 2.99, range 18-40 years old) and 40 non-pregnant women (aged 22.7±3.01, range 18-40 years old) were included as controls. All cases/controls were seronegative for toxoplasmosis, HIV, HBV and HCV. The CD4+ cell counts were 685±256 cell/μl at the first trimester (T1), 740±202 at T2, and 923±203 cell/μl at T3. While the CD8+ cell counts were 451±171 cell/μl at T1, 541±168 at T2, and 753±190 cell/μl at T3. The CD4:CD8 ratios were 1.5±0.64 at T1, 1.4±0.51 at T2, and 1.2±0.36 at T3. Moreover, the mean absolute CD4+ and CD8+ counts for the control group were 1001±232 cell/μl and 717±159 cell/μl respectively. Absolute counts of CD4+ and CD8+ cells in pregnant women were significantly lower as compared to controls (P<0.05). Statistically significant decrease in the CD4+ and CD8+ cell counts was reported during T1 (P<0.05). These values increased significantly during the T2, and was comparable to the controls during T3 (P>0.05). The absolute CD4+ and CD8+ cell counts decreased with age for both groups. Geographical variation was reported for the cell counts between Tripoli and Zwara district at T3. We established reference ranges of CD4+ and CD8+ T-lymphocytes for the Libyan healthy pregnant women and discussed their use as prognostic markers. Further cohorts with greater sample size may be required to define the stage of the disease in relation to the normal CD4+ and CD8+ T lymphocyte count subsets in the Libyan population.