Absolute Lymphocyte Count as a Surrogate Marker of CD4 Count in Monitoring HIV Infected Individuals: A Prospective Study
Introduction: CD4 cell count has been proposed to be substituted by Absolute lymphocyte count in monitoring HIV infected individuals as methods of CD4 cell count and plasma viral estimation require expensive, specialized equipments and highly trained personnel. Aim: To assess the clinical utili...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-05-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/7765/19263_CE(RA1)_F(T)_PF1(ROAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: CD4 cell count has been proposed to be
substituted by Absolute lymphocyte count in monitoring HIV
infected individuals as methods of CD4 cell count and plasma
viral estimation require expensive, specialized equipments and
highly trained personnel.
Aim: To assess the clinical utility of the Absolute Lymphocyte
Count (ALC) to serve as a surrogate marker for predicting a CD4
count < 200 cells/µl in patients with HIV infection in resource
poor countries.
Materials and Methods: A prospective study of 61 patients
with HIV/AIDS was conducted. Sensitivity, specificity, Positive
Predictive Value (PPV), Negative Predictive Value (NPV) of
various ALC cut-offs were computed for CD4 cell count < 200
cells/µl for age < 30 or age ≥ 30 years. Pearson correlation,
Linear regression and Receiver Operating Characteristics
(ROC), were used.
Results: For patients aged ≥ 30 years, sensitivity, specificity,
positive and negative predictive value of ALC <1200 cells/µl
to predict CD4 cell count < 200 cells/µl were 34.48%, 67.5%,
43.48%, 58.69% respectively. For subjects aged < 30 years, these
values were 27.27%, 67.5%, 18.75%, 77.14%, respectively. A
ALC < 1643 was found to have maximal sensitivity for predicting
a CD4 cell count <200/ µl.
Conclusion: Our data revealed good correlation between ALC
and CD4 cell counts but ALC cut-off of 1200 was not a surrogate
marker for CD4 cell count < 200 cells/µl. As we increase the cutoff to <1643/ µl it could be the cost-effective surrogate marker
for CD4 cell counts < 200 cells/µl in resource limited settings. |
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| ISSN: | 2249-782X 0973-709X |