# Quantifications of CD4+ T-Lymphocytes levels in adult sickle cell patients: Examining immunological vulnerability and Vaso-Occlusive crises in a low-resource setting, northwestern Nigeria

## TL;DR

This study examines CD4+ T-lymphocyte levels in adult sickle cell patients in Nigeria, finding lower counts during vaso-occlusive crises, suggesting immunological vulnerability.

## Contribution

The study provides new insights into immunological vulnerability in sickle cell disease patients during crises in a low-resource setting.

## Key findings

- CD4+ T-lymphocyte counts were reduced in patients during vaso-occlusive crises compared to steady states.
- Age group 31–40 had the highest CD4+ counts, while patients aged 40 and above had the lowest.
- No significant correlation was found between CD4+ counts and hemoglobin levels, gender, or age.

## Abstract

Introduction: Sickle Cell Disease (SCD) is a chronic genetic disorder that impairs red blood cell function and contributes to recurrent complications, particularly vaso-occlusive crises. Aim: This study evaluates the level of CD4 + T-lymphocyte counts in adult SCD patients in Northwestern Nigeria, assessing their association with clinical states, and epidemiological factors, to better understand immunological vulnerability. Methods: A descriptive cross-sectional study was conducted at Specialist Hospital Sokoto, 45 adult SCD patients were recruited and stratified by clinical status (steady state versus crisis). CD4 + counts were measured via flow cytometry, and data were analyzed for relationships with haemoglobin levels, gender, and age. Results: Patients in vaso-occlusive crisis observed reduction in CD4 counts compared to those in steady state. However, haemoglobin levels did not show a statistically significant difference between the crisis state (9.43 ± 1.98 g/dL) and steady state (10.08 ± 1.60 g/dL; P = 0.231). Gender-based analysis indicated no significant difference in CD4 + counts (P = 0.403) ++ or haemoglobin levels (P = 0.542) between male and female patients. Age-related analysis showed the highest mean CD4 + count among the 31–40-year age group (1151.80 ± 626.06 cells/µL) and the lowest in patients aged 40 years and above (601.00 ± 0.00 cells/µL). Correlation analysis demonstrated weak and non-significant relationships between CD4 + counts and haemoglobin levels (r = −0.095, P = 0.530), gender (r = −0.126, P = 0.403), and age (r = 0.193, P = 0.198). Conclusion: These findings highlight significant reduced CD4 levels in SCD patients during crises, underscoring the need for regular immunological monitoring.