The CD4+/CD8+ ratio in pulmonary tuberculosis: Systematic and meta-analysis article

Background: the ratio of cd4+/cd8+ has been used as a clinically index to evaluate patients’ immunity. numer-ous researchers have studied cd4+/cd8+ ratio in pulmonary tuberculosis (ptb) patients. however,the change of cd4+/cd8+ ratio remains controversial. we present a meta-analysis of 15 case-control studies to identify the change of cd4+/cd8+ ratio in ptb patients. methods: we assessed heterogeneity of effect estimates within each group using i2 test. subgroup analysis was per-formed to explore the potential source of heterogeneity. to investigate further the potential publication bias,we visu-ally examined the funnel plots. for robustness of results,we performed sensitivity analysis by removing studies. data entry and analyses were carried out with revman 5.2 (the nordic cochrane centre). results: twelve peripheral blood studies were categorized into two subgroups. eight studies presented a significant decrease of cd4+/cd8+ ratio in ptb cases compared to healthy subjects (smd: -0.45; 95% ci -0.65–-0.25; i2 = 7%). other four studies researched on the newly diagnosed patients presented a more seriously and significantly de-crease (smd: -2.17; 95% ci -2.61–-1.74; i2 = 37%). the pooled analysis of bronchoalveolar lavage fluid (balf) stud-ies showed a significant increase of cd4+/cd8+ ratio using flow cytometry (fcm) (smd: 4.75; 95% ci 3.44–6.05; i2 =0%). conclusion: the present meta-analysis indicated that there was a synthetic evidence for the reduced cd4+/cd8+ ratio in peripheral blood of ptb patients,especially newly diagnosed cases. however,the cd4+/cd8+ ratio in balf was increased using method of fcm. © 2015,iranian journal of public health. all rights reserved.