Development of an algorithm of haematologic parameters as surrogate markers for CD4 cell count in resource-limited settings

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dc.contributor.authorAgwata, D.K.
dc.contributor.authorOngus, J.
dc.contributor.authorMbugua, A.
dc.contributor.authorMaturi, P.
dc.contributor.authorNyamari, J.
dc.contributor.authorUwamungu, S.
dc.date.accessioned2016-06-27T07:30:09Z
dc.date.available2016-06-27T07:30:09Z
dc.date.issued2016
dc.descriptionResearch Articleen_US
dc.description.abstractTotal Lymphocyte Count (TLC) has been previously evaluated as a surrogate for CD4 counts in the management of HIV especially in resource-limited settings with varying results. This study developed a clinical algorithm of TLC and other significant haematologic parameters to raise the predictive value of TLC in classifying subjects with CD4 count <350 cells/mm3. Total samples of 215 HIV-seropositive ARVnaïve patients were studied. The Beckman Counter was used for Complete Blood count (CBC), Beckton Dickinson FACS count for CD4 count, and Westergren method for Erythrocyte Sedimentation Rate (ESR). The variables retained as the most significant predictors (at p<0.05) were TLC<2000 cells/mm3 (sensitivity 71.5%, specificity 73.4%, PPV 69.1%, NPV 78.3%), Hb < 12 g/dl (sensitivity 59.8%, specificity 56.2%, PPV 63.3%, NPV 71%) and ESR>30 mm/h(sensitivity 57%, specificity 71%, PPV 66%, NPV 68%). A three-step algorithm of TLC <2000 cells/mm3, Hb<12 g/dl, and ESR>30 mm/h for predicting CD4 count<350 cells/mm3 yielded sensitivity 66%, specificity 82%, PPV 72%, NPV 77% (area under curve AUC 0.79). This algorithm had a higher predictive accuracy making it a better tool than the use of TLC alone in monitoring disease progression in resource-limited settingsen_US
dc.identifier.citationJournal of Medical Laboratory and Diagnosis, Vol. 7(3), pp. 13-19, April 2016 ; DOI: 10.5897/JMLD2015.0120en_US
dc.identifier.issn2141-2618
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/14794
dc.language.isoenen_US
dc.publisherAcademic Journalsen_US
dc.subjectHuman Immunodeficiency Virus (HIV)en_US
dc.subjectHaematologic parametersen_US
dc.subjectSurrogate markersen_US
dc.titleDevelopment of an algorithm of haematologic parameters as surrogate markers for CD4 cell count in resource-limited settingsen_US
dc.typeArticleen_US
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