Mbanya Dora, Assah Felix, Ndembi Nicaise, Kaptue Lazare
Department of Haematology, Faculty of Medicine & Biomedical Sciences, University of Yaoundé I, BP 8046, Yaoundé, Cameroon.
Int J Infect Dis. 2007 Mar;11(2):157-60. doi: 10.1016/j.ijid.2006.02.008. Epub 2006 Jun 9.
In order to improve the monitoring of disease progression and therapeutic effectiveness in the management of HIV/AIDS in a resource-limited setting, this study was carried out to establish a correlation between total lymphocyte counts (TLC) and CD4 lymphocyte counts in HIV-1 infected/AIDS adults in Yaoundé, Cameroon.
Full blood counts, differential white, and CD4 counts were measured in 149 patients using standard methods. The correlation coefficient established correlation between values. Sensitivity, specificity, and positive predictive values were calculated as required.
The mean TLC, CD4 count, and CD4% as well as CD4/CD8 ratios were 1.932+/-0.895 x 10(9)/L, 268+/-183 cells/mm(3), 14.51+/-15.9%, and 0.34+/-0.25, respectively. Only a weak correlation was observed between TLC and CD4 counts (r=0.41, p=0.05). As a predictor of CD4 count, TLC cut-offs <2.0 and <1.0 x 10(9)/L were unable to predict these values reliably, but showed that at TLC cut-offs of <1.0 x 10(9)/L there was a high chance of CD4 counts being under 200 cells/mm(3).
These data suggest that TLC are of limited value in predicting CD4 counts and should not be substituted for CD4 counts whenever possible. However, TLC may be reliably used in designing algorithms and programs for initiating patient management and follow-up in this setting.
为了在资源有限的环境中改善对艾滋病毒/艾滋病管理中疾病进展和治疗效果的监测，本研究旨在确定喀麦隆雅温得地区HIV-1感染/艾滋病成人的总淋巴细胞计数（TLC）与CD4淋巴细胞计数之间的相关性。
采用标准方法对149例患者进行全血细胞计数、白细胞分类计数和CD4计数。通过相关系数确定各值之间的相关性。根据需要计算敏感性、特异性和阳性预测值。
TLC、CD4计数、CD4%以及CD4/CD8比值的平均值分别为1.932±0.895×10⁹/L、268±183个细胞/mm³、14.51±15.9%和0.34±0.25。TLC与CD4计数之间仅观察到弱相关性（r = 0.41，p = 0.05）。作为CD4计数的预测指标，TLC临界值<2.0和<1.0×10⁹/L无法可靠地预测这些值，但表明当TLC临界值<1.0×10⁹/L时，CD4计数有很大机会低于200个细胞/mm³。
这些数据表明，TLC在预测CD4计数方面价值有限，应尽可能不被CD4计数所替代。然而，在设计该环境下启动患者管理和随访的算法及程序时，TLC可被可靠地使用。
