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Establishment of reference CD4+ T cell values for adult Indian population.doc

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EstablishmentofreferenceCD4TcellvaluesforadultIndianpopulation

Thakaretal.AIDSResearchandTherapy2011,8:35 /content/8/1/35 RESEARCH OpenAccess EstablishmentofreferenceCD4+Tcellvaluesfor adultIndianpopulation MadhuriRThakar1*,PhilipRAbraham1,SunilArora2,PachamuthuBalakrishnan3,BhaswatiBandyopadhyay4, AmeetaAJoshi5,KRekhaDevi6,RaviVasanthapuram7,MadhuVajpayee8,AnitaDesai7, JanardhananMohanakrishnan3,KanwarNarain6,KrishnangshuRay9,ShilpaSPatil5,RavinderSingh8,AnujSingla2 andRameshSParanjape1 Abstract Background:CD4+Tlymphocytecountsarethemostimportantindicatorofdiseaseprogressionandsuccessof antiretroviraltreatmentinHIVinfectioninresourcelimitedsettings.ThenationwidereferencerangeofCD4+T lymphocyteswasnotavailableinIndia.ThisstudywasconductedtodeterminereferencevaluesofabsoluteCD4+ TcellcountsandpercentagesforadultIndianpopulation. Methods:Amulticentricstudywasconductedinvolvingeightsitesacrossthecountry.Atotalof1206 (approximately150per/centre)healthyparticipantswereenrolledinthestudy.Theratioofmale(N=645)to female(N=561)of1.14:1.Thehealthystatusoftheparticipantswasassessedbyapre-decidedquestionnaire.At allcenterstheCD4+Tcellcount,percentagesandabsoluteCD3+Tcellcountandpercentageswereestimated usingasingleplatformstrategyandlysenowashtechnique.ThedatawasanalyzedusingtheStatisticalPackage fortheSocialScientist(SPSS),version15)andPrismsoftwareversion5. Results:TheabsoluteCD4+Tcellcountsandpercentagesinfemaleparticipantsweresignificantlyhigherthanthe valuesobtainedinmaleparticipantsindicatingthetruedifferenceintheCD4+Tcellsubsets.Thereferencerange forabsoluteCD4countforIndianmalepopulationwas381-1565cells/μLandforfemalepopulationwas447-1846 cells/μL.ThereferencerangeforCD4%was25-49%formaleand27-54%forfemalepopulation.Thereference valuesforCD3countswere776-2785cells/μLforIndianmalepopulationand826-2997cells/μLforfemale population. Conclusion:ThestudyusedstringentproceduresforcontrollingthetechnicalvariationintheCD4countsacross thesitesandthuscouldestablishtherobustnationalreferencerangesforCD4countsandpercentages.These rangeswillbeh