Total lymphocyte count: a surrogate marker for predicting CD4+ count in enrolled process for antiretroviral therapy in resource-limited settings.
OBJECTIVE
The purpose of the present study was to evaluate the correlation between total lymphocyte count (TLC) and CD4+ count and TLC cut-off for predicting CD4+ count < 200 cells/mm3.


METHODS
The 176-naïve HIV-infected patients from the OPD Khon Kaen Hospital, were recruited for CD4+ count by flow cytometer and TLC by automated cell counter. All results were analyzed by STATA statistical software for sensitivity, specificity, PPV and NPV.


RESULTS
From 176 patients, 61 (34.7%) had CD4+ > 200 cells/mm3 and 115 (65.3%) had CD4+ < 200 cells/mm3. The ROC curve between CD4+ count and TLC showed TLC < 1,800 cells/mm3 could predict CD4+ count < 200 cells/mm3 with 78.26% sensitivity, 73.77% specificity, 84.91% PPV, and 64.29% NPV. The sensitivity was further decreased and specificity was increased when TLC was lower than cut-off.


CONCLUSIONS
The presented finding indicates that the appropriated TLC for predicting CD4+ count. < 200 cells/mm3 was TLC < 1,800 cells/mm3. TLC can also be used as a surrogate marker for starting ARV therapy in resource limited setting.
Susaengrat
Wattanchai
W
Medicine Department, Khon Kaen Hospital, Khon Kaen, Ministry of Public Health, Thailand.
Mitchai
Manthana
M
Leerattanapetch
Niramol
N
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes; D005434:Flow Cytometry; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D012372:ROC Curve; D012680:Sensitivity and Specificity
D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents; D015415:Biomarkers