Evaluating total lymphocyte counts as a substitute for CD4 counts in the follow up of AIDS patients
This study evaluated total lymphocyte count (TLC) as a substitute marker for CD4+ cell counts to identify patients who need prophylaxis against opportunistic infection (CD4 < 200 cells/mm³) and patients with CD4 < 350 cells/mm³ (Brazilian threshold value of CD4 count to define AIDS). We evalua...
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| Format: | Article |
| Language: | English |
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Elsevier
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| Series: | Brazilian Journal of Infectious Diseases |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702007000500005&lng=en&tlng=en |
| _version_ | 1818441270763192320 |
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| author | Ana Luiza Dias Angelo Camila Dias Angelo Alex José Leite Torres André Maurício Costa Ramos Márcia Lima Eduardo Martins Netto Carlos Brites |
| author_facet | Ana Luiza Dias Angelo Camila Dias Angelo Alex José Leite Torres André Maurício Costa Ramos Márcia Lima Eduardo Martins Netto Carlos Brites |
| author_sort | Ana Luiza Dias Angelo |
| collection | DOAJ |
| description | This study evaluated total lymphocyte count (TLC) as a substitute marker for CD4+ cell counts to identify patients who need prophylaxis against opportunistic infection (CD4 < 200 cells/mm³) and patients with CD4 < 350 cells/mm³ (Brazilian threshold value of CD4 count to define AIDS). We evaluated TLC and CD4+ cells count of 1,174 HIV-infected patients, in Salvador, Brazil, from May 2003 to September 2004. CD4+ cell counts were performed by flow cytometry, and TLC was measured with an automated hematological counter. The mean CD4 count was 430 cells/mm³ (range: 4 to 2,531 cells/mm³). Mean TLC was 1,900 cells/mm³ (range: 300 to 6,200 cells/mm³). Using a threshold value of 1,000 cells/mm³ for TLC, the positive predictive value (PPV) was 77% for CD4 < 200 cells/mm³, but the sensitivity was only 29%, while the negative predictive value (NPV) was 88%, with 98% specificity. Similar findings were observed for CD4 count < 350. Using the same threshold value of 1,000 cells/mm³ for TLC, sensitivity was 14%, and specificity 99% (PPV= 94%; NPV=62%). In 70/1,510 (5%) of the samples the sum of CD4 and CD8 cell counts was greater than the TLC and in 27% (419/1,510) this sum was below 65% of the TLC. TLC has a high specificity to identify patients for prophylaxis, but a quite low sensitivity. It is not useful as an alternative to CD4+ T-cell counts as a marker in HIV-infected patients. |
| first_indexed | 2024-12-14T18:25:35Z |
| format | Article |
| id | doaj.art-744183065ce54f3f97e70faf8ef7480d |
| institution | Directory Open Access Journal |
| issn | 1678-4391 |
| language | English |
| last_indexed | 2024-12-14T18:25:35Z |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-744183065ce54f3f97e70faf8ef7480d2022-12-21T22:51:56ZengElsevierBrazilian Journal of Infectious Diseases1678-439111546647010.1590/S1413-86702007000500005S1413-86702007000500005Evaluating total lymphocyte counts as a substitute for CD4 counts in the follow up of AIDS patientsAna Luiza Dias Angelo0Camila Dias Angelo1Alex José Leite Torres2André Maurício Costa Ramos3Márcia Lima4Eduardo Martins Netto5Carlos Brites6Universidade Federal da BahiaUniversidade Federal da BahiaUniversidade Federal da BahiaUniversidade Federal da BahiaUniversidade Federal da BahiaUniversidade Federal da BahiaUniversidade Federal da BahiaThis study evaluated total lymphocyte count (TLC) as a substitute marker for CD4+ cell counts to identify patients who need prophylaxis against opportunistic infection (CD4 < 200 cells/mm³) and patients with CD4 < 350 cells/mm³ (Brazilian threshold value of CD4 count to define AIDS). We evaluated TLC and CD4+ cells count of 1,174 HIV-infected patients, in Salvador, Brazil, from May 2003 to September 2004. CD4+ cell counts were performed by flow cytometry, and TLC was measured with an automated hematological counter. The mean CD4 count was 430 cells/mm³ (range: 4 to 2,531 cells/mm³). Mean TLC was 1,900 cells/mm³ (range: 300 to 6,200 cells/mm³). Using a threshold value of 1,000 cells/mm³ for TLC, the positive predictive value (PPV) was 77% for CD4 < 200 cells/mm³, but the sensitivity was only 29%, while the negative predictive value (NPV) was 88%, with 98% specificity. Similar findings were observed for CD4 count < 350. Using the same threshold value of 1,000 cells/mm³ for TLC, sensitivity was 14%, and specificity 99% (PPV= 94%; NPV=62%). In 70/1,510 (5%) of the samples the sum of CD4 and CD8 cell counts was greater than the TLC and in 27% (419/1,510) this sum was below 65% of the TLC. TLC has a high specificity to identify patients for prophylaxis, but a quite low sensitivity. It is not useful as an alternative to CD4+ T-cell counts as a marker in HIV-infected patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702007000500005&lng=en&tlng=enLymphocyte countsCD4 countsAIDS |
| spellingShingle | Ana Luiza Dias Angelo Camila Dias Angelo Alex José Leite Torres André Maurício Costa Ramos Márcia Lima Eduardo Martins Netto Carlos Brites Evaluating total lymphocyte counts as a substitute for CD4 counts in the follow up of AIDS patients Brazilian Journal of Infectious Diseases Lymphocyte counts CD4 counts AIDS |
| title | Evaluating total lymphocyte counts as a substitute for CD4 counts in the follow up of AIDS patients |
| title_full | Evaluating total lymphocyte counts as a substitute for CD4 counts in the follow up of AIDS patients |
| title_fullStr | Evaluating total lymphocyte counts as a substitute for CD4 counts in the follow up of AIDS patients |
| title_full_unstemmed | Evaluating total lymphocyte counts as a substitute for CD4 counts in the follow up of AIDS patients |
| title_short | Evaluating total lymphocyte counts as a substitute for CD4 counts in the follow up of AIDS patients |
| title_sort | evaluating total lymphocyte counts as a substitute for cd4 counts in the follow up of aids patients |
| topic | Lymphocyte counts CD4 counts AIDS |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702007000500005&lng=en&tlng=en |
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