title: A microchip approach for practical label-free CD4+ T-cell counting of HIV-infected subjects in resource-poor settings.
abstract: 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.
authors.affiliation: Surgical Services and Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Xuanhong
authors.initials: X
authors.lastname: Cheng
authors.forename: Daniel
authors.initials: D
authors.lastname: Irimia
authors.forename: Meredith
authors.initials: M
authors.lastname: Dixon
authors.forename: Joshua C
authors.initials: JC
authors.lastname: Ziperstein
authors.forename: Utkan
authors.initials: U
authors.lastname: Demirci
authors.forename: Lee
authors.initials: L
authors.lastname: Zamir
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Tompkins
authors.forename: Mehmet
authors.initials: M
authors.lastname: Toner
authors.forename: William R
authors.initials: WR
authors.lastname: Rodriguez
mesh_terms: 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
chemical_list: D000911:Antibodies, Monoclonal; D015483:HIV Antibodies