Association between CD4 T-Cell Count and Genital Mycoplasma and Other Vaginal Pathogens among Women in Anambra State, Nigeria

Abstract

Background: Genital tract infections are important causes of reproductive morbidity, while alterations in immune status may influence susceptibility to genital microbial colonization and infection. However, the relationship between CD4 T-cell count and genital Mycoplasma, Ureaplasma, and other vaginal pathogens remains insufficiently characterized in Nigerian populations. This study assessed the relationship between CD4 count and genital pathogens among women in Anambra State, Nigeria. Methods: A cross-sectional study was conducted among women in Anambra State. Participants underwent assessment of CD4 T-cell count and microbiological investigation for genital Mycoplasma and Ureaplasma species, as well as other vaginal pathogens including Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, Candida species, haemolytic streptococci, and Trichomonas vaginalis. Mean CD4 counts were compared between pathogen-positive and pathogen-negative participants, with statistical significance set at p < 0.05. Results: No significant association was observed between CD4 count and Mycoplasma genitalium (p = 0.209), Mycoplasma hominis (p = 0.337), Ureaplasma urealyticum (p = 0.296), or Ureaplasma parvum (p = 0.580). Similarly, CD4 count was not significantly associated with Staphylococcus aureus, E. coli, K. pneumoniae, Candida species, alpha haemolytic streptococci, beta-haemolytic streptococci, or T. vaginalis (p > 0.05). However, participants positive for E. faecalis had a significantly lower mean CD4 count than those who were negative (p = 0.043). Conclusion: CD4 T-cell count was not significantly associated with most genital mycoplasma or vaginal pathogens investigated. The significant association observed with E. faecalis suggests a possible relationship between immune status and specific bacterial colonization. Further multicentre studies are warranted to clarify these relationships and their implications for women's reproductive health..