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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...

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Autores principales: Karanth, Suman S., Rau, N. R., Gupta, Anurag, Kamath, Asha, Shanbhogue, Vikram, Pruthvi, B. C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
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.
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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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