A Study of Alternate Biomarkers in HIV Disease and Evaluating their Efficacy in Predicting T CD4+ Cell Counts and Disease Progression in Resource Poor Settings in Highly Active Antiretroviral Therapy (HAART) Era
Introduction: Human Immunodeficiency Virus (HIV), the causative agent of AIDS, has been a challenge to medical fraternity since it was first discovered in 1983. About 40 million people are living with HIV infection globally and 99% of the infected people are in south East Asia (SEA). Traditional...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2013-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/3138/17%20-%205306_PF1(M)_E(C)_F(T)_PF1(PUH)_PFA(H)_1.pdf |
| Summary: | Introduction: Human Immunodeficiency Virus (HIV), the causative
agent of AIDS, has been a challenge to medical fraternity
since it was first discovered in 1983. About 40 million people
are living with HIV infection globally and 99% of the infected
people are in south East Asia (SEA). Traditionally, HIV disease
and progression, initiation of HAART and response to therapy
is monitored by assessing in regular intervals, the T CD4+ cell
counts and plasma HIV/RNA viral load. Resource poor, low and
low – middle income group countries still have no finances to
acquire infrastructure and scientific technology for performing
such tests.
Objectives: Since very few studies are available, they have
demonstrated the role of alternate biomarkers that can be
used to predict CD4 cell counts and thereby, monitor HIV disease progression and HAART. We aimed to measure certain
haematological parameters in HIV seropositive patients and to
evaluate their efficacy in predicting TCD4+ cell counts.
Methods: The study group included 250 HIV seropositive
patients with an age range of 18-65 years. 140(56%) males
and 110(44%) females were included in the study. Absolute
TCD4+cell counts and CD8+T cell counts were measured by
using a flow cytometer. (MMWR Recommendations and Reports,
1992) TLC; HB%, AEC and ESR were estimated by using
conventional haematological methods. CRP was evaluated by
latex agglutination test (Immuno CRP Latex Agglutination Test).
Results: Among the tested haematological markers, a TLC of
<1800 cells/mm3
showed high specificity (100%) in predicting
CD4 counts of < 200 cells/mm3
, with an accuracy of 61.46%.
Haemoglobin and Absolute Eosinophilic counts showed high
specificities of 84.09% and 94.32% respectively in predicting
CD4 counts which were below 350 cells/mm3
. ESR with 98.98%
sensitivity and AEC which had 83.67% sensitivity were able to
predict CD4 counts of <200 cells/mm3
.
Conclusion: Among the tested biomarkers, it was seen that
Absolute Eosinophilic counts of more than 550 cells/mm3
, Blood
Haemoglobin which was less than 10 g%, ESR which measured
more than 20 mm, CRP values of >1.2 and TLC of <1800 cells/
mm3
could be helpful in predicting CD4 cell counts of < 350 and
<200 cells/mm3
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| ISSN: | 2249-782X 0973-709X |