Evaluation of Surrogate Markers for Prediction of CD4 Counts in People Living with Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome
Jyoti Kotwal, Jasmita Dass*, Atul Kotwal, Atul Kakar, Sabina Langer, Amrita Saraf and Achamma Jacob
Sir Ganga Ram Hospital, Ârmed Forces Medical Services, New Delhi, India
- *Corresponding Author:
- Dr. Jasmita
Consultant, Department of Hematology
Sir Ganga Ram Hospital, New Delhi, India
E-mail: [email protected]
Received March 15, 2016; Accepted April 29, 2016; Published May 09, 2016
Citation: Kotwal J, Dass J, Kotwal A, Kakar A, Langer S, et al. (2016) Evaluation of Surrogate Markers for Prediction of CD4 Counts in People Living with Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome. J AIDS Clin Res 7:573. doi:10.4172/2155-6113.1000573
Copyright: © 2016 Kotwal J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
India is a developing country where resources are limited. HIV/ AIDS is an ominous public health problem faced by our population and the affordability of patients for 3-6 monthly monitoring of CD4 counts becomes difficult for most patients. The intent of the study was to identify parameters on complete blood counts that can predict a CD4 count of <200/μL. We found that an absolute lymphocyte count obtained by a 5-part cell counter >1250/μL is predictive of a CD4 count <200/μL with a sensitivity and specificity of 87.3% and 70.0% respectively. In addition, a haemoglobin value <11.15g/dL is also a good predictor of the CD4 count <200/μL. The combination of both Hb <11.15g/dl and ALC counter <1250/μL was like a confirmatory test with a specificity of 92.2% and a NPV of 79.5%. Hemoglobin and absolute lymphocyte counts obtained on automated cell counter are robust, cost-effective and easily available methods to follow up PLHA patients and patients on ART. These can effectively predict the CD4 count <200/μL and are especially useful in a developing country where the cost of these tests is one-fifth of flow cytometry.