Al-Mughales Jamil A
Department of Clinical Microbiology and Immunology, King Abdul-Aziz University, Jeddah, Kingdom of Saudi Arabia.
Department of Clinical Laboratories-Diagnostic Immunology Division, King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
HIV AIDS (Auckl). 2023 Oct 5;15:599-610. doi: 10.2147/HIV.S431139. eCollection 2023.
This study aimed to test the validity of a composite score using complete blood count (CBC) for monitoring HIV patients receiving antiretroviral therapy (ART) in the absence of viral load and CD4 count.
This retrospective cohort study analyzed the laboratory data of 82 HIV patients who had pre- and post-treatment viral load, CD4 count, and CBC data. Pre- and post-treatment data were pooled to analyze the correlation of CBC parameters with Polymerase Chain Reaction (PCR) ranks and their performance in indicating a CD4 count<200 cells/mm3 using the Operating Characteristics Curve (ROC), with the determination of cutoffs. A score combining the significant parameters was tested to predict a CD4 count of <200.
Total lymphocyte count (TLC), percentage (TLP), and hemoglobin concentration (Hb) were the most significant parameters, showing negative correlations with PCR (Spearman's Rho = -0.357 to -0.242). The risk of acquired immunodeficiency syndrome (AIDS) was independently associated with TLC<1345 cells/mm3 (OR=2.92), TLP<29.07% (OR=3.53), and Hb<10.55 mg/dL (OR=3.60). A combined score of 2-3 indicated a CD4 count<200 with an odds ratio of 8.3-86.7.
The proposed 3-parameter score combining the use of TLC, TLP, and Hb, is an affordable and practical approach that may have clinical utility in monitoring HIV patients receiving ART in low-resource settings.
本研究旨在检验在缺乏病毒载量和 CD4 细胞计数的情况下，使用全血细胞计数（CBC）综合评分监测接受抗逆转录病毒治疗（ART）的 HIV 患者的有效性。
这项回顾性队列研究分析了 82 例 HIV 患者治疗前后的病毒载量、CD4 细胞计数和 CBC 数据。将治疗前和治疗后的数据分析合并，以分析 CBC 参数与聚合酶链反应（PCR）分级的相关性，以及它们在使用操作特征曲线（ROC）指示 CD4 细胞计数<200 个细胞/mm³ 时的表现，并确定临界值。对结合显著参数的评分进行测试，以预测 CD4 细胞计数<200。
总淋巴细胞计数（TLC）、百分比（TLP）和血红蛋白浓度（Hb）是最显著的参数，与 PCR 呈负相关（Spearman 相关系数 = -0.357 至 -0.242）。获得性免疫缺陷综合征（AIDS）的风险与 TLC<1345 个细胞/mm³（OR = 2.92）、TLP<29.07%（OR = 3.53）和 Hb<10.55 mg/dL（OR = 3.60）独立相关。综合评分为 2 - 3 表明 CD4 细胞计数<200，比值比为 8.3 - 86.7。
所提出的结合使用 TLC、TLP 和 Hb 的三参数评分是一种经济实用的方法，可能在资源匮乏地区监测接受 ART 的 HIV 患者方面具有临床应用价值。
