CD4-IMMUNODEFICIENCY-VIRUS( LYMPHOCYTES AND OPPORTUNISTIC INFECT IONSAND NEOPLASMS IN PATIENTS WITH THE HUMAN)

BACKGROUND: The CD4+ lymphocytes are the principal target cell for the human immunodeficiency virus (HIV). Their depletion originates a very severe cell immunosuppression, which conditions the appearance of opp ortunistic infections and neoplasms characteristic of AIDS. The aim of this study was to evaluate whether there is a relation between the de gree of cell immunosuppression and the type of opportunistic infection s and neoplasms which these patients develop in Spain. METHODS: The CD 4+ lymphocyte counts in 400 adults with HIV infection who developed op portunistic infections or neoplasms were retrospectively reviewed (198 7-1991). This determination was carried out during between two months prior to diagnosis of AIDS (CDC, 1987) to one month after such diagnos is. RESULTS: The results allowed opportunistic infections to be classi fied into three groups according to the grade of immunosuppression: 1) opportunistic infections with more than 0.2 x 10(9) CD4+ lymphocytes/ l (45-60% of cases of tuberculosis, esophageal candidiasis and enterit is by Isospora belli); 2) opportunistic infections with 0-0,2 x 10(9) CD4/l (87-100% of the cases of pneumonia by Pneumocystis carinii, ence phalic toxoplasmosis, visceral leishmaniasis and enteritis by Cryptosp oridium); 3) opportunistic infections with 0-0.1 x 10(9) CD4 lymphocyt es/l (70-100% of the cases of systemic cryptococcosis, retinitis by cy tomegalovirus, progessive multifocal leukoencephalopathy and infection by Mycobacterium avium-intracellulare). With respect to the neoplasms , Kaposi's sarcoma was observed in patients with different degrees of immunosuppression. Seventy-five and 80% of the patients with non Hodgk in's lymphoma and primary cerebral lymphoma had less than 0.2 x 10(9)/ l and less than 0.1 x 10(9)/l CD4+ lymphocytes, respectively. CONCLUSI ONS: The CD4 lymphocyte counts may predict the type of opportunistic i nfections which patients with the human immunodeficiency virus infecti on may develop.