Total Lymphocyte Count as surrogate marker for CD4 Cell Count in HIV-Infected Individuals in Gondar University Hospital, Northwest Ethiopia 英文参考文献.docVIP

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Total Lymphocyte Count as surrogate marker for CD4 Cell Count in HIV-Infected Individuals in Gondar University Hospital, Northwest Ethiopia 英文参考文献.doc

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Total Lymphocyte Count as surrogate marker for CD4 Cell Count in HIV-Infected Individuals in Gondar University Hospital, Northwest Ethiopia 英文参考文献

Wondimenehetal.AIDSResearchandTherapy2012,9:21 /content/9/1/21 RESEARCH OpenAccess TotalLymphocyteCountassurrogatemarkerfor CD4CellCountinHIV-InfectedIndividualsin GondarUniversityHospital,NorthwestEthiopia YitayihWondimeneh1,GetachewFerede1*,GizachewYismaw2andDagnachewMuluye2 Abstract Background:ThehighcostofCD4countestimationinresource-limitedcountriesisamajorchallengeininitiating patientsonhighlyactiveantiretroviraltherapy(HAART).Therefore,assessmentofinexpensiveandsimplelaboratory diagnosticmarkerismandatorytodiagnoseimmuno-suppression. Objective:Toevaluateutilityoftotallymphocytecount(TLC)assurrogatemarkerforCD4countinHIV-infected patients. MaterialsandMethods:Inthiscrosssectionalstudy,400ART-naiveHIV-positivepatientsenrolledinGondar UniversityHospital,fromMarch2011toMay2011,weretestedforCD4countTLC.Thecutoffsweredetermined as:200cells/μLforCD4countand1200cells/μLforTLCbyusingBDFACScountandCELLDYN1800Flow Cytometrysrespectively.SpearmancorrelationbetweenTLCandCD4cellcountwereassessed.Sensitivity, specificity,positiveandnegativepredictivevaluesfordifferentageagroup,TLC≤1200wascomputedforCD4 count≤200cells/cu.mm. Results:Among400ARTnaiveHIVinfectedpatients,278(69.5%)werefemales.Themeanageofthestudy participantswas33.7.TLCandCD4countwerepositivelycorrelated(r=0.33,p=0.001).ATLCof≤1200cells/mm3 wasfoundtohaveasensitivity(32.86%),specificity(95.33%),PPV(79.7%),andNPV(71.9%)forpredictingaCD4 countof200cells/mm3. Conclusion:ThisstudyshowedthatlowsensitivityandspecificityofTLCasasurrogatemeasureforCD4count. Moreover,CD4cellcountsof200cells/mm3werefoundin96cases(24%)withTLCsof≤1200cells/mm3.Thus,1 in4individualswouldhavebeendeprivedofneededtreatment.Therefore,werecommendkeeponexpansionof accesstoCD4counter. Keywords:Totallymphocytecount,CD4counts,HAART,Surrogatemarker Introduction thislaboratorymeasurementoritscostmaybeprohibi- Thesaddleof HIVin resource-limited countriesiswide tive, resulting in the need for an alternative, surrogate andalargeproportionofHIVpatien