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Correlation Analysis on total lymphocyte count and CD4 count in HIV-infected Patients: A Retrospective Evaluation

Journal of Huazhong University of Science and Technology(Medical Sciences) 2011年第5期31卷 712-716页

作者：王宇明梁淑英于二曼郭金玲李自钊王哲杜玉开 Henan Provincial Medical Academy Department of Epidemiology and Biostatistics College of Public Health Zhengzhou University Center for AIDS/STD Control and Prevention Department of Health of Henan Province Institute for Infection Disease Control and Prevention Henan Provincial Center for Disease Control and Prevention Department of Maternal and Child Health Care and Adolescent Hygiene School of Public Health Tongji Medical College Huazhong University of Science and Technology

CD4 count is the standard method for determining eligibility for highly active antiretroviral therapy （HAART） and monitoring HIV/AIDS disease progression, but it is not widely available in resource-limited settings. This study examined the correlation between total lymphocyte count （TLC） and CD4 count of HIV-infected patients before and after HAART, and assessed the thresholds of TLC for making decisions about the initiation and for monitoring HAART. A retrospective study was performed, and 665 HIV-infected patients with TLC and CD4 count from four counties （Shangcai, Queshan, Shenqiu and Weishi） were included in the study. Pearson correlation and receiver operating characteristic （ROC） were used. TLC and CD4 count after HAART was significantly increased as compared with pre-HAART （P〈0.01）. An overall positive correlation was noted between TLC and CD4 count （pre-HAART, r=0.73, P=0.0001; follow-up HAART, r=0.56, P=0.0001）. The ROC curve between TLC and CD4 count showed that TLC ≤ 1200 cells/mm3 could predict CD4 〈 200 cells/mm3 with a sensitivity of 71.12%, specificity of 66.35% at pre-HAART. After 12-month HAART, the optimum prediction for CD4 count 〈 200 cells/mm3 was a TLC ≤ 1300 cells/mm3, with a sensitivity of 63.27%, and a specificity of 74.84%. Further finding indicated that TLC change was positively correlated to CD4 change （r=0.77, P=0.0001） at the time point of 12-month treatment, and the best prediction point of TLC change for CD4 increasing was 135 cells/mm3. TLC and its change can be used as a surrogate marker for CD4 count and its change of HIV-infected individuals for making decisions about the initiation and for monitoring HAART in resource-limited settings.

关键词： HIV/AIDS CD4 count total lymphocyte count highly active antiretroviral therapy

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