Evaluation of Three Medium Throughput Flow Cytometers for Monitoring People Living with HIV in Resources Limited Laboratories: How to Choose?
- *Corresponding Author:
- Inwoley A
Diagnostic and Research Center on AIDS and Infectious Diseases
University Hospital of Treichville, Abidjan, Ivory Coast
Tel: +225 42 12 73 73
E-mail: [email protected]
Received Date: November 15, 2016; Accepted Date: January 13, 2017; Published Date: January 20, 2017
Citation: Inwoley A, Adiko AC, Kabran M, Aboli-Affi R, Diomande A, et al. (2017) Evaluation of Three Medium Throughput Flow Cytometers for Monitoring People Living with HIV in Resources Limited Laboratories: How to Choose?. J Immuno Biol 2:118.
Copyright: © 2017 Inwoley KA, 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.
Objective: Absolute and percentage CD4+ T-lymphocytes counts are useful in monitoring people living with HIV. In spite of point-of-care development, CD4 testing in some laboratories of resources-limited countries still use flow cytometers from many manufacturers. We evaluated three flow cytometers (FACSCOUNT CD4/CD4%, GUAVA Auto CD4/CD4%, CYFLOW Counter® CD4/CD4%) and brought out choice criteria according to laboratory resources. Methods: CD4 percent and absolute count obtained with 180 HIV-infected patients (adults and children) with evaluated platforms (FACSCOUNT CD4/CD4%, GUAVA Auto CD4/CD4%, CYFLOW Counter CD4/CD4%) were compared with those provided by FACSCalibur TruCount®. Agreement was analyzed using Bland-Altman analysis. We also carried out a Comparative analysis of technical and operational characteristics to identify strengths and weaknesses of each tested cytometer. Results: The median CD4 percentage and absolute count obtained with FACSCOUNT and CYFLOW were similar to those of FACSCALIBUR. By contrast, GUAVA showed higher values. Bland-Altman analysis did not show measurement error. However, GUAVA and CYFLOW gave a relative high bias with mean difference respectively -69 and +27CD4 cells/μl. The overall bias of CD4 percentage were >5% for the evaluated cytometers. There was a good interclass agreement (Kappa ≥ 0.78) and good measurement precision (coefficient of variation <10%) with the 3 cytometers. Only FACSCOUNT showed good stability (CV<5%) even for stained and unstained samples within 24 and 48 hours after blood collection. FACSCOUNT, GUAVA and CYFLOW have good technical performances. Conclusion: Though we found differences in their operational characteristics, it appears very important to know how to use these kinds of cytometers before making a choice for peripheral laboratory in limited-resources countries.