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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
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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952389/ https://www.ncbi.nlm.nih.gov/pubmed/24678463 http://dx.doi.org/10.4103/2231-0770.127413 |
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author | Karanth, Suman S. Rau, N. R. Gupta, Anurag Kamath, Asha Shanbhogue, Vikram Pruthvi, B. C. |
author_facet | Karanth, Suman S. Rau, N. R. Gupta, Anurag Kamath, Asha Shanbhogue, Vikram Pruthvi, B. C. |
author_sort | Karanth, Suman S. |
collection | PubMed |
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 | Online Article Text |
id | pubmed-3952389 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-39523892014-03-27 Utility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study Karanth, Suman S. Rau, N. R. Gupta, Anurag Kamath, Asha Shanbhogue, Vikram Pruthvi, B. C. Avicenna J Med Original Article 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. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC3952389/ /pubmed/24678463 http://dx.doi.org/10.4103/2231-0770.127413 Text en Copyright: © Avicenna Journal of Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Karanth, Suman S. Rau, N. R. Gupta, Anurag Kamath, Asha Shanbhogue, Vikram Pruthvi, B. C. Utility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study |
title | 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_short | 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 |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952389/ https://www.ncbi.nlm.nih.gov/pubmed/24678463 http://dx.doi.org/10.4103/2231-0770.127413 |
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