Assessment of two POC technologies for CD4 count in Morocco
Abstract Background In the era of “test and treat strategy”, CD4 testing remains an important tool for monitoring HIV-infected individuals. Since conventional methods of CD4 count measurement are costly and cumbersome, POC CD4 counting technique are more affordable and practical for countries with l...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | AIDS Research and Therapy |
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| Online Access: | http://link.springer.com/article/10.1186/s12981-020-00289-w |
| _version_ | 1828438807760863232 |
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| author | Elmir Elharti Halima Abbadi Rajae Bensghir Kamal Marhoum El Filali Hajar Elmrabet Hicham Oumzil |
| author_facet | Elmir Elharti Halima Abbadi Rajae Bensghir Kamal Marhoum El Filali Hajar Elmrabet Hicham Oumzil |
| author_sort | Elmir Elharti |
| collection | DOAJ |
| description | Abstract Background In the era of “test and treat strategy”, CD4 testing remains an important tool for monitoring HIV-infected individuals. Since conventional methods of CD4 count measurement are costly and cumbersome, POC CD4 counting technique are more affordable and practical for countries with limited resources. Before introducing such methods in Morocco, we decided to assess their reliability. Methods In this study 92 blood samples from HIV-infected patients, were tested by PIMA and FACSPresto to derive CD4 count. Flow cytometry using FacsCalibur, was used as reference method for CD4 count comparison. Linear regression, Bland–Altman analysis were performed to assess correlation and agreement between these POC methods and the reference method. In addition, sensitivity and specificity, positive predictive value (PPV), negative predictive value (NPV) and misclassification percentage at 350 and 200 CD4 count thresholds; were also determined. Finally, because FACSPresto can also measure hemoglobin (Hb) concentration, 52 samples were used to compare FACSPresto against an automated hematology analyzer. Results The coefficient of determination R2 was 0.93 for both methods. Bland–Altman analysis displayed a mean bias of − 32.3 and − 8.1 cells/µl for PIMA and FACSPresto, respectively. Moreover, with a threshold of 350 CD4 count, PIMA displayed a sensitivity, specificity, PPV, NPV, were 88.57%, 94.12%, 91.18%, 92.31%; respectively. FACSPresto showed 88.23%, 96.23%, 93.75% and 92.73%; respectively. Furthermore, the upward misclassification percentage was 8.57 and 5.88%, for PIMA and FACSPresto, respectively; whereas the downward misclassification percentage was 7.84% and 7.54%; respectively. With 200 cells/µl threshold, PIMA had a sensitivity, specificity, PPV and NPV of 83.33%, 98.53%, 93.75% and 95.71%, respectively. Regarding FACSPresto, sensitivity, specificity, PPV and NPV was 82.35%, 98.57%, 88.57% and 95.83%; respectively. Upward misclassification percentage was 5.56% and 5.88%, for PIMA and FACSPresto, respectively; whereas downward misclassification percentage was 4.41% and 4.29%; respectively. Finally, the hemoglobin measurement evaluation displayed an R2 of 0.80 and a mean bias of − 0.12 with a LOA between − 1.75 and 1.51. Conclusion When compared to the reference method, PIMA and FACSPresto have shown good performance, for CD4 counting. The introduction of such POC technology will speed up the uptake of patients in the continuum of HIV care, in our country. |
| first_indexed | 2024-12-10T20:13:56Z |
| format | Article |
| id | doaj.art-6a9d8e5eebbd408a936a1a04bf5a6533 |
| institution | Directory Open Access Journal |
| issn | 1742-6405 |
| language | English |
| last_indexed | 2024-12-10T20:13:56Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | AIDS Research and Therapy |
| spelling | doaj.art-6a9d8e5eebbd408a936a1a04bf5a65332022-12-22T01:35:15ZengBMCAIDS Research and Therapy1742-64052020-06-011711910.1186/s12981-020-00289-wAssessment of two POC technologies for CD4 count in MoroccoElmir Elharti0Halima Abbadi1Rajae Bensghir2Kamal Marhoum El Filali3Hajar Elmrabet4Hicham Oumzil5National Reference Laboratory for HIV, Department of Virology, National Institute of HygieneNational Reference Laboratory for HIV, Department of Virology, National Institute of HygieneInfectious Diseases Clinic, Ibn Rochd University Hospital CenterInfectious Diseases Clinic, Ibn Rochd University Hospital CenterNational Reference Laboratory for HIV, Department of Virology, National Institute of HygieneNational Reference Laboratory for HIV, Department of Virology, National Institute of HygieneAbstract Background In the era of “test and treat strategy”, CD4 testing remains an important tool for monitoring HIV-infected individuals. Since conventional methods of CD4 count measurement are costly and cumbersome, POC CD4 counting technique are more affordable and practical for countries with limited resources. Before introducing such methods in Morocco, we decided to assess their reliability. Methods In this study 92 blood samples from HIV-infected patients, were tested by PIMA and FACSPresto to derive CD4 count. Flow cytometry using FacsCalibur, was used as reference method for CD4 count comparison. Linear regression, Bland–Altman analysis were performed to assess correlation and agreement between these POC methods and the reference method. In addition, sensitivity and specificity, positive predictive value (PPV), negative predictive value (NPV) and misclassification percentage at 350 and 200 CD4 count thresholds; were also determined. Finally, because FACSPresto can also measure hemoglobin (Hb) concentration, 52 samples were used to compare FACSPresto against an automated hematology analyzer. Results The coefficient of determination R2 was 0.93 for both methods. Bland–Altman analysis displayed a mean bias of − 32.3 and − 8.1 cells/µl for PIMA and FACSPresto, respectively. Moreover, with a threshold of 350 CD4 count, PIMA displayed a sensitivity, specificity, PPV, NPV, were 88.57%, 94.12%, 91.18%, 92.31%; respectively. FACSPresto showed 88.23%, 96.23%, 93.75% and 92.73%; respectively. Furthermore, the upward misclassification percentage was 8.57 and 5.88%, for PIMA and FACSPresto, respectively; whereas the downward misclassification percentage was 7.84% and 7.54%; respectively. With 200 cells/µl threshold, PIMA had a sensitivity, specificity, PPV and NPV of 83.33%, 98.53%, 93.75% and 95.71%, respectively. Regarding FACSPresto, sensitivity, specificity, PPV and NPV was 82.35%, 98.57%, 88.57% and 95.83%; respectively. Upward misclassification percentage was 5.56% and 5.88%, for PIMA and FACSPresto, respectively; whereas downward misclassification percentage was 4.41% and 4.29%; respectively. Finally, the hemoglobin measurement evaluation displayed an R2 of 0.80 and a mean bias of − 0.12 with a LOA between − 1.75 and 1.51. Conclusion When compared to the reference method, PIMA and FACSPresto have shown good performance, for CD4 counting. The introduction of such POC technology will speed up the uptake of patients in the continuum of HIV care, in our country.http://link.springer.com/article/10.1186/s12981-020-00289-wHIV managementCD4 countPOCPIMAFACSPrestoMorocco |
| spellingShingle | Elmir Elharti Halima Abbadi Rajae Bensghir Kamal Marhoum El Filali Hajar Elmrabet Hicham Oumzil Assessment of two POC technologies for CD4 count in Morocco AIDS Research and Therapy HIV management CD4 count POC PIMA FACSPresto Morocco |
| title | Assessment of two POC technologies for CD4 count in Morocco |
| title_full | Assessment of two POC technologies for CD4 count in Morocco |
| title_fullStr | Assessment of two POC technologies for CD4 count in Morocco |
| title_full_unstemmed | Assessment of two POC technologies for CD4 count in Morocco |
| title_short | Assessment of two POC technologies for CD4 count in Morocco |
| title_sort | assessment of two poc technologies for cd4 count in morocco |
| topic | HIV management CD4 count POC PIMA FACSPresto Morocco |
| url | http://link.springer.com/article/10.1186/s12981-020-00289-w |
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