Attili V Satya Suresh, Sundar Shyam, Singh V P, Rai Madhukar
IMS, BHU, Room 66, Hostel 8 AIIMS Ansari Nagar, 110029 New Delhi, India.
J Infect. 2005 Jul;51(1):41-6. doi: 10.1016/j.jinf.2004.08.022.
The CD4 lymphocyte count had ethnic variability as observed in many studies. In populations with CD4 counts inherently lower than in the West, the Center for Disease Control and Prevention (CDC) classification system of HIV-infected individuals may not be appropriate. As there is no such criterion currently available for ethnic north Indians HIV-patients, we undertook this study to assess the applicability of the western case definition in north Indian HIV patients.
The CD4 counts of 40 normal and 376 HIV-infected north Indian adults attending to ID clinic, SS hospital, Varanasi were estimated by flowcytometry. The mean CD4 counts were estimated and compared between CDC groups A, B and C and controls. Receiver operator characteristic (ROC) curves were generated to determine the cut-off that correlated best with clinical staging for this population.
For CDC groups A, B and C, the mean CD4 counts/mul (upper limits of the 95% CI) were 380.3, 249.2 and 120.9, while the mean CD4 levels in healthy volunteers was 818.4.
The mean CD4 count among normal north Indians is significantly lower than that in the western population and parallels that of the Chinese. When categorized based on the Center for Disease Control and Prevention (CDC) classification system, the mean CD4 counts in HIV-infected individuals was lower. Categories of CD4 counts >280, 120-280 and < or =120 cells/microl correlate better with disease progression among HIV-infected individuals. A longitudinal study is required before guidelines for the India population can be devised.
正如许多研究所观察到的，CD4淋巴细胞计数存在种族差异。在CD4计数天生低于西方人群的群体中，美国疾病控制与预防中心（CDC）对HIV感染者的分类系统可能并不适用。由于目前尚无针对印度北部HIV患者的此类标准，我们开展了这项研究以评估西方病例定义在印度北部HIV患者中的适用性。
通过流式细胞术对在瓦拉纳西SS医院传染病诊所就诊的40名正常印度北部成年人及376名HIV感染的印度北部成年人的CD4计数进行了估算。对CDC A、B和C组及对照组的平均CD4计数进行了估算和比较。绘制了受试者工作特征（ROC）曲线以确定与该人群临床分期相关性最佳的临界值。
对于CDC A、B和C组，平均CD4计数/μl（95%CI上限）分别为380.3、249.2和120.9，而健康志愿者的平均CD4水平为818.4。
正常印度北部人群的平均CD4计数显著低于西方人群，与中国人的平均CD4计数相近。根据美国疾病控制与预防中心（CDC）分类系统进行分类时，HIV感染者的平均CD4计数较低。CD4计数>280、120 - 280和≤120个细胞/μl的类别与HIV感染者的疾病进展相关性更好。在制定针对印度人群的指南之前，需要进行纵向研究。
