Determination of eligibility to antiretroviral therapy in resource limited settings using total lymphocyte counts, hemoglobin and body mass index among HIV positive patients

Authors

Abstract

Abstract Background: Acquired Immunodeficiency Syndrome is a serious public health problem in Ethiopia. CD4+ T cell count testing is the standard method for determining eligibility for antiretroviral therapy. However, automation for CD4+ T cell count is not widely available in sub-Saharan Africa including Ethiopia. Objective: This study was to determine eligibility for antiretroviral therapy in resource-limited settings using total lymphocyte counts, hemoglobin and body mass index among HIV positive patients. Materials and methods: CD4+ T cell count was determined using Becton Dickinson FACS count analyzer. Total lymphocyte count and hemoglobin concentration were measured by a Cell Dyne 1800 hematology analyzer and body mass index was determined. Correlation of total lymphocyte count, hemoglobin and body mass index with CD4+ T cell count was determined by Pearson’s correlation coefficient and p-value. Results: The correlation between CD4+ T cell count and Total Lymphocyte Count (TLC) was not strong, but the association between CD4+ T cell count and TLC was highly significant and correlation between CD4+ T cell counts with hemoglobin were very weak. The sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of TLC using threshold value of 1000 cells/mm3 for CD4+ T cell counts <350 cells/mm3 were 3% , 94%, 17% and 71%, respectively. Total lymphocyte count threshold of 1750 cells/mm3 were the better predictor of CD4+ T cell counts of <350 cells/mm3 when compared to < 200 cells/mm3. Conclusion: TLC showed weak correlation with CD4+ T cell counts but the association between CD4+ T cell count with TLC was significant (p<0.0001). The TLC threshold of 1750 cells/mm3 were the most accurate predictors of CD4+ T cell counts of <350 cells/mm3. Therefore, the significant association of TLC with CD4+ T cell count may suggest that TLC could be used as marker for CD4+ T cell count in determining anti-retroviral treatment initiation when CD4+ T cell count is not available particularly in rural settings where laboratory facilities are lacking. [Ethiop. J. Health Dev. 2013;27(1):48-54]

Published

2016-09-29

How to Cite

Asrie, F., Gelaw, B., Alem, M., Moges, F., & Awoke, T. (2016). Determination of eligibility to antiretroviral therapy in resource limited settings using total lymphocyte counts, hemoglobin and body mass index among HIV positive patients. The Ethiopian Journal of Health Development, 27(1). Retrieved from https://ejhd.org/index.php/ejhd/article/view/181

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