Absolute lymphocyte count: A cost-effective substitute to CD4 count in HIV positive patients

Abstract

Background and Aim: The most characteristic feature of HIV/AIDS is a selective depletion of CD4 T helper/inducer subsets of T- cells. Depletion of CD4+ T cells is a hallmark of AIDS apart from anaemia, leucopenia and thrombocytopenia. Monitoring of CD4 count is crucial for an effective treatment. This study was done to evaluate the role of absolute lymphocyte count (ALC) as an alternative to CD4 count in HIV positive patients. Material and Methods: A prospective observational study was carried out after taking the institutional ethics committee approval for the period of one year in the department of Pathology of a tertiary care hospital in Gujarat. 100 HIV positive patients consenting to be the part of the study were included. Complete blood counts (CBC), CD4 and CD8 counts were done for all patients following stringent quality control protocols. Statistical analysis was done to evaluate the correlation between various parameters. Results: Out of 100 cases 54 of them had leucopenia. Out of 100 cases 65% had lymphopenia.35% had total WBC count ROC curve shows tradeoff between sensitivity (True positivity) and 1- specificity (1- False positivity rate). Conclusion: ALC is a good surrogate test for HIV management and has a significant strong positive correlation with CD4 cell count. This methodology is also accessible to a larger population; flow cytometry being expensive and mostly unavailable.