T-cell enumeration from dried blood spots by quantifying rearranged T-cell receptor-beta genes.
Significant hurdles remain to large-scale implementation of medical interventions in the developing world due to the lack of a modern diagnostic infrastructure. This is especially pertinent to the international roll-out of antiretroviral drugs to treat HIV, which ideally includes a CD4 T-cell count to determine eligibility. We designed a novel technique to estimate mature T-cell numbers by calculating the amount of rearranged T-cell receptor beta genes from dried blood spots of HIV-infected individuals in the United States and Uganda. It was observed that the rearranged T-cell receptor beta count correlated well with total lymphocyte counts from both study populations (Baltimore R=0.602, Uganda R=0.497; p<0.001) and the ability for this measurement to determine antiretroviral initiation was similar to total lymphocyte counts, which can be used to determine eligibility in HIV+children. This technique as well as other dried blood spot based technologies could increase the diagnostic and monitoring capabilities in resource-limited settings.
Redd
Andrew D
AD
Laboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA. aredd2@jhmi.edu
Ciccone
Emily J
EJ
Nakigozi
Gertrude
G
Keruly
Jeanne C
JC
Ndyanabo
Anthony
A
Iga
Boaz
B
Gray
Ronald H
RH
Serwadda
David
D
Quinn
Thomas C
TC
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001800:Blood Specimen Collection; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D003906:Developing Countries; D005260:Female; D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D014454:Uganda; D014481:United States
D044966:Anti-Retroviral Agents