scholarly journals Body Mass Index, Haemoglobin, and Total Lymphocyte Count as a Surrogate for CD4 Count in Resource Limited Settings

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Louis Boafo Kwantwi ◽  
Bismark Kwame Tunu ◽  
Daniel Boateng ◽  
Dan Yedu Quansah

Background. In view of the lack of evidence on the possibility of an economically viable, easy, and readily available biomarker to substitute the traditional role of CD4 counts in HIV disease progression, this study seeks to investigate the potential use of body mass index (BMI), haemoglobin (Hb), and total lymphocyte count (TLC) as surrogate biomarkers for monitoring the disease. Methods. This cross-sectional study was undertaken at the antiretroviral clinic (ART) of the Bomso Hospital, Kumasi, Ghana. We recruited 384 individuals who were 18 years or older and confirmed HIV seropositive patients. Blood samples were assayed for TLC and Hb. Weight and height were determined and BMI was calculated. Result. At a cut-off point of 12.15 g/dL, Hb had sensitivity and specificity of 73.9% and 56.8%, respectively, whereas BMI had 69.6% and 80.1% sensitivity and specificity, respectively. The sensitivity and specificity were also 100% among the studied participants at a cut-off point of 1200 mm−3 for TLC. There was a significant positive correlation between CD4 count and Hb (rho 0.262, p=0.0001), BMI (rho 0.301, p=0.0001), and TLC (rho 0.834, p=0.0001). Conclusion. The study demonstrates that TLC, Hb, and BMI may provide some useful prognostic information independent of that provided by CD4 count.

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Enoch Odame Anto ◽  
Christian Obirikorang ◽  
Emmanuel Acheampong ◽  
Bright Amankwaa ◽  
Bright Oppong Afranie ◽  
...  

We evaluated the individual and combined levels of urine dipstick and total lymphocyte count (TLC) as surrogate markers for CD4 count in a low-resource community in Ghana. This cross-sectional study recruited 200 HIV-infected patients from the Saint Francis Xavier Hospital, Assin Fosu, Ghana. Complete blood count, CD4 count, and urine dipstick analysis were measured for participants. The threshold values were determined as <350 cells/μl for CD4, <1200 cells/μl for TLC, and ≥+ on urine dipstick analysis. The mean age of participants was 43.09 years. Proteinuria ≥ + [aOR = 4.30 (3.0–18.5)], leukocyturia ≥ + [aOR = 2.91 (1.33–12.5)], hematuria ≥ + [aOR = 2.30 (1.08–9.64)], and TLC < 1200 cells/μl [aOR = 3.26 (3.94–15.29)] were significantly associated with increased risk of CD4 count < 350 cells/μl. Using the individual markers, the best substitute marker for predicting CD4 count < 350 cells/μl was proteinuria at a cutoff point ≥ 2++, AUC of 0.973, sensitivity of 97.6%, specificity of 100.0%, PPV of 100.0%, and NPV of 89.1%. A combination of ≤ 1200 TLC + ≥ 2++ (leukocyturia + proteinuria + hematuria) yielded an AUC of 0.980, sensitivity (72.8%), specificity (100.0%), PPV (100.0%), and NPV (97.9%). Proteinuria could serve as a noninvasive screening tool, but the combination of proteinuria, leukocyturia, hematuria, and TLC serves as a better substitute marker for CD4 count in monitoring the disease progression among HIV patients in low-resource communities.


2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Ardo Sanjaya ◽  
Christine Sugiarto ◽  
Ronald Jonathan

HIV infection is a chronic infection of the immune system with a target of CD4 cells. Total lymphocyte count (TLC) can be done in resource-limited areas and are able to be used as a substitute to CD4 count. An increase in CD8 count can disturb the correlation between CD4 and TLC especially during the late clinical stage.Objective of this research is to find out the correlation of total lymphocyte count with CD4 count and to find out the influence of the clinical staging on the correlation of total lymphocyte count and CD4 count.This study is an observational, analytical and cross sectional study using the medical records of Klinik Teratai RSHS Bandung. The data is sorted according to the WHO clinical staging and are analyzed using Pearson’s correlation and Fisher’s transformation with α=0.05. The results showed that TLC have a correlation with CD4 count in all stadiums (r: 0,501-0,684, p<0,01). There is no significant difference of the correlation coefficients between the clinical stages (p>0.05). There is a correlation between TLC and CD4 count on HIV infected patients and there is no significant decrease of correlation of TLC and CD4 count on HIV infected patients with worsening of the WHO clinical stages. Keywords: CD4 count, total lymphocyte count, HIV/AIDS


2007 ◽  
Vol 23 (2) ◽  
pp. 297-304 ◽  
Author(s):  
Rosana Farah Simony ◽  
Suely Godoy Agostinho Gimeno ◽  
Sandra Roberta Gouveia Ferreira ◽  
Laércio Joel Franco

The objective of this study was to evaluate the impact of different body mass index (BMI) ranges associated with the risk of diabetes and hypertension in Japanese-Brazilians. This cross-sectional study was based on data from 1,330 Japanese-Brazilians > 30 years of age who participated in a population-based survey on the prevalence of diabetes mellitus and associated diseases. Glucose tolerance status was classified according to WHO criteria and blood pressure levels according to the VI-JNC. Odds ratios for diabetes and hypertension were calculated for different BMI ranges; for different BMIs, sensitivity and specificity for percentiles 25, 50, 75, 90 and 95 were obtained. Increased odds ratios for diabetes mellitus and hypertension were observed with BMI values > 25kg/m². The 50th percentile corresponded to the highest sensitivity and specificity for the identification of risk for both diseases. Our results suggest that BMI values proposed by WHO should also be useful for this group of Japanese descendants in the assessment of risk for DM and hypertension.


2007 ◽  
Vol 62 (6) ◽  
pp. 955-960 ◽  
Author(s):  
F. R. Liu ◽  
F. Guo ◽  
J. J. Ye ◽  
C. F. Xiong ◽  
P. L. Zhou ◽  
...  

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