Absolute lymphocyte count: Alternate marker for CD4 count in HIV positive patients in resources restrained areas

Amruta A Patil; Kalpana R. Sulhyan; Rahul Rajbhar

Volume : VII, Issue : IX, September - 2018

Absolute lymphocyte count: Alternate marker for CD4 count in HIV positive patients in resources restrained areas

Amruta A Patil, Kalpana R. Sulhyan, Rahul Rajbhar

Abstract :

BACKGROUND: All the HIV positive patients with progression of disease need HAART and prophylaxis against opportunistic infections. It is started when CD4 cell count falls below critical level. An alternate surrogate marker absolute lymphocyte count [ALC] is relatively cheaper investigation for monitoring HIV positive individuals. ALC is studied for its efficacy and its correlation with the CD4 count is established.

AIMS AND OBJECTIVES: We studied the correlation between CD4 count and ALC count. Also a critical value of absolute lymphocyte count (ALC) is found out at which there is maximum correlation with the CD4 count below 200/cmm is seen.

METHODS: The statistical analysis of correlation between CD4 count and ALC was done by Spearman�s correlation coefficient. Also the diagnostic utility of change in ALC was evaluated as a marker of CD4 change by calculating the receiver operator characteristic (ROC) curves.

RESULTS: A total 1162 patients were studied. The ROC curve between ALC values and CD4 count of less than 200/micro liter showed significance (p value <0.05). Considering the optimum cut off value of ALC as 200/micro liter, an ALC value of 1459/cmm was derived which showed maximum correlation with sensitivity of 77.5% and specificity of 72.3%.

CONCLUSION: ALC has a positive correlation with CD4 count and is a useful surrogate marker for CD4 count. This surrogate marker can be used as parameter for starting HAART in non developed and developing countries and funds saved in costly investigations can be used to provide HAART to maximum patients.