A microchip approach for practical label-free CD4+ T-cell counting of HIV-infected subjects in resource-poor settings.
Simple affordable CD4 cell counting is urgently needed to stage and monitor HIV-infected patients in resource-limited settings. To address the limitations of current approaches, we designed a simple, label-free, and cost-effective CD4 cell counting device using microfluidic technology. We previously described the fabrication of a microfluidic system for high-efficiency isolation of pure populations of CD4+ T cells based on cell affinity chromatography operated under controlled flow. Here, we compare the performance of a microfluidic CD4 cell counting device against standard flow cytometry in 49 HIV-positive subjects over a wide range of absolute CD4 cell counts. We observed a close correlation between CD4 cell counts from the microchip device and measurements by flow cytometry, using unprocessed whole blood from HIV-positive adult subjects. Sensitivities for distinguishing clinically relevant thresholds of 200, 350, and 500 cells/microL are 0.86, 0.90, and 0.97, respectively. Specificity is 0.94 or higher at all thresholds. This device can serve as a functional cartridge for fast, accurate, affordable, and simple CD4 cell counting in resource-limited settings.
Cheng
Xuanhong
X
Surgical Services and Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Irimia
Daniel
D
Dixon
Meredith
M
Ziperstein
Joshua C
JC
Demirci
Utkan
U
Zamir
Lee
L
Tompkins
Ronald G
RG
Toner
Mehmet
M
Rodriguez
William R
WR
D000328:Adult; D000911:Antibodies, Monoclonal; D018791:CD4 Lymphocyte Count / Q000379:methods*; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006678:HIV / Q000276:immunology*; D015483:HIV Antibodies; D006679:HIV Seropositivity / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D008297:Male; D046210:Microfluidic Analytical Techniques / Q000379:methods*; D008875:Middle Aged; D015166:Monitoring, Immunologic; D012680:Sensitivity and Specificity
D000911:Antibodies, Monoclonal; D015483:HIV Antibodies