Correlation of CD4+ T cell count with total lymphocyte count, haemoglobin and erythrocyte sedimentation rate levels in human immunodeficiency virus type-1 disease

Abstract

Background: Studies in human immunodeficiency virus (HIV) infected adults have demonstrated association of total lymphocyte count (TLC) <1200/mm 3 and subseqnent disease progression or mortality. The association of other surrogate makers such as haemoglobin (Hb), and erythrocyte sedimentation rate (ESR) with CD4 count and disease progression has also been suggested. This study was carried out to determine the relationship of CD4-positive T lymphocyte counts with TLC, Hb and ESR in HIV-infected individuals. Methods: The study population comprised of 215 antiretroviral treatment naive HIV-1 infected adults. The CD4 positive T cell counts, TLC, Hb and ESR of study participants were measured. Spearman's rank order correlation and Receiver Operating Characteristic were used for statistical analyses. Result: The sensitivity, specificity, positive and negative likelihood ratios for cut-off value of TLC <1200/mm 3 for predicting CD4 counts <200 cells/mm 3 and <350 cells/mm 3 were 9.4%, 100%, not measurable and 1.1, and 6.1 %, 98.8 %, 5.13 and 0.95, respectively. The association of Hb (<10, 11, 12 g/dl and <10, 12, 14 g/dl for CD4 counts <200 cells/mm 3 and <350 cells/mm 3, respectively), and ESR (<10, 20 and 30 mm fall after 1 hour) with these two CD4 counts cut-off values were suboptimal. Conclusion: This study reveals the poor association of TLC, Hb, and ESR with CD4 counts in HIV infected adults, thus highlighting the need to review the utility of these surrogate markers, for predicting CD4 counts in people living with HIV/AIDS.