title: Correlation of CD4+ T cell Count with Total Lymphocyte Count, Haemoglobin and Erythrocyte Sedimentation Rate Levels in Human Immunodeficiency Virus Type-1 Disease.
abstract: BACKGROUND
  Studies in human immunodeficiency virus (HIV) infected adults have demonstrated association of total lymphocyte count (TLC) <1200/mm (3) and subsequent disease progression or mortality. The association of other surrogate makers such as haemoglobin (Hb), and erythrocyte sedimentation rate (ESR) with CD4 count and disease progression has also been suggested. This study was carried out to determine the relationship of CD4-positive T lymphocyte counts with TLC, Hb and ESR in HIV-infected individuals.
  
  
  METHODS
  The study population comprised of 215 antiretroviral treatment naïve HIV-1 infected adults. The CD4 positive T cell counts, TLC, Hb and ESR of study participants were measured. Spearman's rank order correlation and Receiver Operating Characteristic were used for statistical analyses.
  
  
  RESULTS
  The sensitivity, specificity, positive and negative likelihood ratios for cut-off value of TLC <1200/mm (3) for predicting CD4 counts <200 cells/mm (3) and <350 cells/mm (3) were 9.4 %, 100 %, not measurable and 1.1, and 6.1 %, 98.8 %, 5.13 and 0.95, respectively. The association of Hb (<10,11,12 g/dl and <10,12,14 g/dl for CD4 counts <200 cells/mm (3) and <350 cells/mm (3) , respectively), and ESR (<10, 20 and 30 mm fall after 1 hour) with these two CD4 counts cut-off values were suboptimal.
  
  
  CONCLUSIONS
  This study reveals the poor association of TLC, Hb, and ESR with CD4 counts in HIV infected adults, thus highlighting the need to review the utility of these surrogate markers, for predicting CD4 counts in people living with HIV/AIDS.
authors.affiliation: Associate Professor, Department of Microbiology, AFMC, Pune-40.
authors.forename: Sourav
authors.initials: S
authors.lastname: Sen
authors.affiliation: Intem, Safdarjung Hospital, New Delhi.
authors.forename: Akshat
authors.initials: A
authors.lastname: Vyas
authors.affiliation: Classified Specialist (Dermatology), STI & HIV/AIDS, CH (SC), Pune-40.
authors.forename: Sunil
authors.initials: S
authors.lastname: Sanghi
authors.affiliation: Senior Advisor (Med & Rheumat), Army Hospital (R&R), Delhi Cantt.
authors.forename: K
authors.initials: K
authors.lastname: Shanmuganandan
authors.affiliation: Senior Advisor (Pathology & Microbiology), CH (NC).
authors.forename: R M
authors.initials: RM
authors.lastname: Gupta
authors.affiliation: Brig Med, HQ MG & G Area, C/o 56 APO.
authors.forename: Brig Ketoki
authors.initials: BK
authors.lastname: Kapila
authors.affiliation: Professor & HOD, Department of Microbiology, AFMC, Pune-40.
authors.forename: A K
authors.initials: AK
authors.lastname: Praharaj
authors.affiliation: Associate Professor, Department of Microbiology, AFMC, Pune-40.
authors.forename: Satish
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Associate Professor, Department of Pathology, AFMC, Pune-40.
authors.forename: R B
authors.initials: RB
authors.lastname: Batra
keywords: Erythrocyte sedimentation rate; Haemoglobin; Human immunodeficiency virus; Total lymphocyte count