Daka Deresse, Loha Eskindir
Faculty of Public Health, Hawassa University, Hawassa, Ethiopia.
AIDS Res Ther. 2008 Dec 22;5:26. doi: 10.1186/1742-6405-5-26.
CD4 count is a standard measure of immunodeficiency in adults infected with HIV to initiate and monitor highly active antiretroviral therapy; however, it may not be feasible in resource poor countries. There is a need to have another marker of immunodeficiency that is less resource demanding.
The objective of this study was to assess the relationship between total lymphocyte count and CD4 count in one of the resource poor countries, Ethiopia.
This was a retrospective evaluation. A total of 2019 cases with total lymphocyte and CD4 counts from three hospitals (Yirgalem, Hossana and Arba-Minch) were included in the study. Pearson correlation, linear regression and Receiver Operating Characteristic (ROC) were used.
For adults, the sensitivity, specificity, positive and negative predictive values of TLC < 1200 cells/mm3 to predict CD4 count < 200 cells/mm3 were 41%, 83.5%, 87.9% and 32.5%, respectively. For subjects aged less than 18 years, these values were 20.2%, 87%, 82% and 27.1%, respectively. A TLC </= 1780 cells/mm3 was found to have maximal sensitivity (61%) and specificity (62%) for predicting a CD4 cell count of < 200 cells/mm3. Meanwhile, a TLC </= 1885 cells/mm3 would identify only 59% of patients with CD4 count of < 350 cells/mm3(sensitivity, 59%; and specificity, 61%). The combined sensitivity and specificity for patients above 40 years of age was greater.
Our data revealed low sensitivity and specificity of TLC as a surrogate measure for CD4 count.
CD4细胞计数是成人感染HIV后启动和监测高效抗逆转录病毒治疗时免疫缺陷的标准指标；然而，在资源匮乏的国家可能不可行。需要有另一种对资源需求较少的免疫缺陷标志物。
本研究的目的是评估资源匮乏国家之一埃塞俄比亚的总淋巴细胞计数与CD4细胞计数之间的关系。
这是一项回顾性评估。研究纳入了来自三家医院（伊尔加莱姆、霍萨纳和阿尔巴-明奇）的2019例有总淋巴细胞和CD4细胞计数的病例。采用了Pearson相关性分析、线性回归分析和受试者工作特征（ROC）分析。
对于成年人，总淋巴细胞计数（TLC）<1200个细胞/mm³预测CD4细胞计数<200个细胞/mm³的敏感性、特异性、阳性预测值和阴性预测值分别为41%、83.5%、87.9%和32.5%。对于年龄小于18岁的受试者，这些值分别为20.2%、87%、82%和27.1%。发现TLC≤1780个细胞/mm³预测CD4细胞计数<200个细胞/mm³时具有最大敏感性（61%）和特异性（62%）。同时，TLC≤1885个细胞/mm³只能识别59%的CD4细胞计数<350个细胞/mm³的患者（敏感性为59%，特异性为61%）。40岁以上患者的联合敏感性和特异性更高。
我们的数据显示总淋巴细胞计数作为CD4细胞计数替代指标时敏感性和特异性较低。
