Utility of Total Lymphocyte Count as an Affordable Surrogate for CD4 Lymphocyte Count in HIV Infected Nepali Patients

Introduction: AIDS is a disease of human immune system caused by Human Immunodeficiency Virus. Immunologically it is defined as the condition characterized by CD4 cell count less than 200 cells/mm3. In developing countries the resource are limited so that CD4 count is not easily available in every parts of the country and is too expensive to afford. The Total lymphocyte count (TLC) has been found to be an inexpensive and useful surrogate marker of CD4 count for staging disease, timing of initiation of Antiretroviral Therapy (ART) and response to ART. Objective: To study the relationship between the T-cell subsets (CD3 and CD4) in HIV patient and to evaluate TLC as a surrogate marker of CD4 T-cell count. Methods: A total of 303 samples were evaluated from July 2010 to September 2010 at NPHL for this study. The blood sample were analyzed by FACS count and the result were analyzed by SPSS 16.0 to determine sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) to find out the relationship between the T cells subsets and evaluate TLC as a surrogate marker of CD4 T cell count for the diagnosis of CD4 count