Utility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study

Background: Standard methods of CD4 counts and plasma viral load estimation require specialized equipment, highly trained personnel and are extremely expensive. This remains a major challenge for the initiation of anti-retroviral therapy for patients in resource-limited settings. Objective: To asses...

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Autores principales:	Suman S Karanth, N R Rau, Anurag Gupta, Asha Kamath, Vikram Shanbhogue, B C Pruthvi
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2014
Materias:	cd4 count human immunodeficiency virus surrogate marker total lymphocyte count Medicine R
Acceso en línea:	https://doaj.org/article/123e3486905348aebf804126052349ea
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spelling	oai:doaj.org-article:123e3486905348aebf804126052349ea2021-12-02T16:24:51ZUtility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study2231-07702249-446410.4103/2231-0770.127413https://doaj.org/article/123e3486905348aebf804126052349ea2014-01-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/2231-0770.127413https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Background: Standard methods of CD4 counts and plasma viral load estimation require specialized equipment, highly trained personnel and are extremely expensive. This remains a major challenge for the initiation of anti-retroviral therapy for patients in resource-limited settings. Objective: To assess the clinical utility of the total lymphocyte count (TLC) to serve as a surrogate marker for predicting a CD4 counts <350 cell/mm 3 in patients with HIV. Materials and Methods: A prospective study of 200 consecutive newly detected highly active anti-retroviral therapy (HAART) naïve HIV patients admitted over a one year period was conducted. Linear regression, Pearson correlation and receiver operating characteristic (ROC) curves were used to calculate the relationship between TLC and CD4 counts. Results: A significant correlation between TLC and CD4 count was observed (r = 0.682, P < 0.001). TLC cut off of 1200 cell/mm 3 as a predictor of CD4 count <350 cell/mm 3 had 73.1% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 51.4% negative predictive value (NPV). Raising the cutoff to 1500 cells/mm 3 improved the sensitivity to 82.1% with 88.2% specificity, 96.5% PPV, 44.4% NPV. The ROC curve demonstrated highest area under curve (AUC = 0.8) for TLC of 1500 cell/mm 3 . Conclusion: The study showed that TLC cutoff value of 1500 cells/mm 3 was a cost effective surrogate marker for CD4 counts <350 cells/mm 3 in resource-limited settings.Suman S KaranthN R RauAnurag GuptaAsha KamathVikram ShanbhogueB C PruthviThieme Medical and Scientific Publishers Pvt. Ltd.articlecd4 counthuman immunodeficiency virussurrogate markertotal lymphocyte countMedicineRENAvicenna Journal of Medicine, Vol 04, Iss 01, Pp 1-4 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	cd4 count human immunodeficiency virus surrogate marker total lymphocyte count Medicine R
spellingShingle	cd4 count human immunodeficiency virus surrogate marker total lymphocyte count Medicine R Suman S Karanth N R Rau Anurag Gupta Asha Kamath Vikram Shanbhogue B C Pruthvi Utility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study
description	Background: Standard methods of CD4 counts and plasma viral load estimation require specialized equipment, highly trained personnel and are extremely expensive. This remains a major challenge for the initiation of anti-retroviral therapy for patients in resource-limited settings. Objective: To assess the clinical utility of the total lymphocyte count (TLC) to serve as a surrogate marker for predicting a CD4 counts <350 cell/mm 3 in patients with HIV. Materials and Methods: A prospective study of 200 consecutive newly detected highly active anti-retroviral therapy (HAART) naïve HIV patients admitted over a one year period was conducted. Linear regression, Pearson correlation and receiver operating characteristic (ROC) curves were used to calculate the relationship between TLC and CD4 counts. Results: A significant correlation between TLC and CD4 count was observed (r = 0.682, P < 0.001). TLC cut off of 1200 cell/mm 3 as a predictor of CD4 count <350 cell/mm 3 had 73.1% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 51.4% negative predictive value (NPV). Raising the cutoff to 1500 cells/mm 3 improved the sensitivity to 82.1% with 88.2% specificity, 96.5% PPV, 44.4% NPV. The ROC curve demonstrated highest area under curve (AUC = 0.8) for TLC of 1500 cell/mm 3 . Conclusion: The study showed that TLC cutoff value of 1500 cells/mm 3 was a cost effective surrogate marker for CD4 counts <350 cells/mm 3 in resource-limited settings.
format	article
author	Suman S Karanth N R Rau Anurag Gupta Asha Kamath Vikram Shanbhogue B C Pruthvi
author_facet	Suman S Karanth N R Rau Anurag Gupta Asha Kamath Vikram Shanbhogue B C Pruthvi
author_sort	Suman S Karanth
title	Utility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study
title_short	Utility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study
title_full	Utility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study
title_fullStr	Utility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study
title_full_unstemmed	Utility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study
title_sort	utility of total lymphocyte count as a surrogate for absolute cd4 count in the adult indian hiv population: a prospective study
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2014
url	https://doaj.org/article/123e3486905348aebf804126052349ea
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Utility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study

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