Mwamburi D Mkaya, Ghosh Mayurika, Fauntleroy Jim, Gorbach Sherwood L, Wanke Christine A
Division of Geographic Medicine and Infectious Diseases, Tufts-New England Medical Center, Boston, Massachusetts 02111, USA.
Am J Trop Med Hyg. 2005 Jul;73(1):58-62.
Understanding the total lymphocyte count (TLC)-CD4 count relationship could aide design predictive instruments for making clinical decisions during antiretroviral therapy, especially in underserved resource-poor settings. We performed multiple regression analyses to assess the prediction of CD4 count using TLC on 771 participants with 4,836 visits. In linear and logistic regression TLC, hemoglobin, gender, history of AIDS, and weight predicted CD4 count and CD4 < 200, respectively, before and after highly active antiretroviral therapy (HAART) use. On HAART, the adjusted odds ratios (OR) for TLC < 1500 (optimal TLC cutoff) were 5.1 (95%CI 4.0, 6.5; P < 0.001), and off HAART, 4.6 (95%CI 3.4, 6.2: P < 0.001) with high predictive power. TLC predicts CD4 count and CD4 < 200 cells/microL well during HAART. Including the additional factors improves performance. TLC is simple and inexpensive and can be used in many ways to develop clinical decision-making tools in underserved resource-poor settings during HAART therapy.
了解总淋巴细胞计数（TLC）与CD4计数之间的关系有助于设计预测工具，以便在抗逆转录病毒治疗期间做出临床决策，尤其是在服务不足的资源匮乏地区。我们对771名参与者的4836次就诊情况进行了多元回归分析，以评估使用TLC预测CD4计数的情况。在使用高效抗逆转录病毒疗法（HAART）之前和之后，在线性和逻辑回归中，TLC、血红蛋白、性别、艾滋病病史和体重分别预测了CD4计数和CD4＜200。在HAART治疗中，TLC＜1500（最佳TLC临界值）的调整比值比（OR）为5.1（95%CI 4.0，6.5；P＜0.001），在未使用HAART时，为4.6（95%CI 3.4，6.2：P＜0.001），具有较高的预测能力。在HAART治疗期间，TLC能很好地预测CD4计数和CD4＜200个细胞/微升的情况。纳入其他因素可提高预测性能。TLC简单且成本低廉，可用于多种方式，以在HAART治疗期间为服务不足的资源匮乏地区开发临床决策工具。
