Generic placeholder image

Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Research Article

Better Predictive Value of Lymphocyte Count and Hemoglobin for CD4 Level of HIV Patients

Author(s): Zheng-Rong Gao*, Zheng Yuan, Chang-song Zhao, Ru-gang Zhao and Qiang Zhang*

Volume 21, Issue 1, 2023

Published on: 18 January, 2023

Page: [73 - 80] Pages: 8

DOI: 10.2174/1570162X21666221222104349

Price: $65

Abstract

Objective: HIV patients are prone to infection and difficult to treat, which mainly manifests itself in decreased CD4+ T cells in the body. Therefore, the predictive value of lymphocyte count and hemoglobin for CD4+ levels in HIV patients was discussed in the prospective study.

Methods: 125 HIV patients (aged >18 or < 80 years) were recruited. Pearson chi-square test was used to explore the correlation between CD4+ content and blood-related parameters in HIV patients. Univariate and multivariate logistic regression analyses were used to calculate ORs for each variable. In addition, receiver ROC curves were constructed to assess each factor's accuracy and sensitivity in diagnosing CD4+.

Results: Lymphocyte count and hemoglobin were significantly correlated with CD4+. In terms of multivariate logistic regression level, there was a significant correlation between lymphocyte count (OR = 3.170, 95% CI: 1.442-6.969, P = 0.004), hemoglobin (OR = 2.545, 95% CI: 1.148- 5.646, P = 0.022) and CD4+ content in HIV patients. Based on the neural network model, the level of lymphocyte and hemoglobin might be the predictive indexes of CD4+ level. We find the high-risk warning indicator of CD4+ level: 3 < lymphocyte (109/L) < 3.6, and 150 < hemoglobin (g/L) < 200.

Conclusion: Better predictive value of lymphocyte count and hemoglobin for CD4+ level of HIV patients.

Keywords: Lymphocyte, hemoglobin, CD4 level, HIV, neural network model, predictive value.

Graphical Abstract
[1]
Azoulay E, Russell L, Van de Louw A, et al. Diagnosis of severe respiratory infections in immunocompromised patients. Intensive Care Med 2020; 46(2): 298-314.
[http://dx.doi.org/10.1007/s00134-019-05906-5] [PMID: 32034433]
[2]
Guegan H, Robert-Gangneux F. Molecular diagnosis of Pneumocystis pneumonia in immunocompromised patients. Curr Opin Infect Dis 2019; 32(4): 314-21.
[http://dx.doi.org/10.1097/QCO.0000000000000559] [PMID: 31107250]
[3]
Salzer HJF, Schäfer G, Hoenigl M, et al. Clinical, diagnostic, and treatment disparities between HIV-infected and non-hiv-infected immunocompromised patients with Pneumocystis jirovecii pneumonia. Respiration 2018; 96(1): 52-65.
[http://dx.doi.org/10.1159/000487713] [PMID: 29635251]
[4]
Lee WS, Prévost J, Richard J, et al. CD4- and time-dependent susceptibility of hiv-1-infected cells to antibody-dependent cellular cytotoxicity. J Virol 2019; 93(10): e01901-18.
[http://dx.doi.org/10.1128/JVI.01901-18] [PMID: 30842324]
[5]
Vohra P, Jamatia K, Subhada B, Tiwari RC, Althaf MSN, Jain C. Correlation of CD4 counts with oral and systemic manifestations in HIV patients. J Family Med Prim Care 2019; 8(10): 3247-52.
[http://dx.doi.org/10.4103/jfmpc.jfmpc_767_19] [PMID: 31742150]
[6]
Durandt C, Potgieter JC, Mellet J, et al. HIV and haematopoiesis. S Afr Med J 2019; 109(8b): 40-5.
[http://dx.doi.org/10.7196/SAMJ.2019.v109i8b.13829] [PMID: 31662148]
[7]
Akdag D, Knudsen AD, Thudium RF, et al. Increased risk of anemia, neutropenia, and thrombocytopenia in people with human immunodeficiency virus and well-controlled viral replication. J Infect Dis 2019; 220(11): 1834-42.
[http://dx.doi.org/10.1093/infdis/jiz394] [PMID: 31414119]
[8]
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med 2007; 147(8): 573-7.
[http://dx.doi.org/10.7326/0003-4819-147-8-200710160-00010] [PMID: 17938396]
[9]
Pang Y, Liu H, Zhou C, Huang J, Gu H, Zhang Z. Pretreatment of ultra-weak fiber bragg grating hydrophone array based on cubic spline interpolation using intensity compensation. Sensors (Basel) 2022; 22(18): 6814.
[http://dx.doi.org/10.3390/s22186814] [PMID: 36146165]
[10]
Azoulay E, Mokart D, Kouatchet A, Demoule A, Lemiale V. Acute respiratory failure in immunocompromised adults. Lancet Respir Med 2019; 7(2): 173-86.
[http://dx.doi.org/10.1016/S2213-2600(18)30345-X] [PMID: 30529232]
[11]
Lei ZG, Ren XH, Wang SS, Liang XH, Tang YL. Immunocompromised and immunocompetent mouse models for head and neck squamous cell carcinoma. OncoTargets Ther 2016; 9: 545-55.
[PMID: 26869799]
[12]
Dropulic LK, Lederman HM. Overview of infections in the immunocompromised host. Microbiol Spectr 2016; 4: 10.
[http://dx.doi.org/10.1128/microbiolspec.DMIH2-0026-2016] [PMID: 27726779]
[13]
Ehrenkranz PD, Baptiste SL, Bygrave H, et al. The missed potential of CD4 and viral load testing to improve clinical outcomes for people living with HIV in lower-resource settings. PLoS Med 2019; 16(5): e1002820.
[http://dx.doi.org/10.1371/journal.pmed.1002820] [PMID: 31141516]
[14]
Prabhu S, Harwell JI, Kumarasamy N. Advanced HIV: diagnosis, treatment, and prevention. Lancet HIV 2019; 6(8): e540-51.
[http://dx.doi.org/10.1016/S2352-3018(19)30189-4] [PMID: 31285181]
[15]
Crowe S, Turnbull S, Oelrichs R, Dunne A. Monitoring of human immunodeficiency virus infection in resource-constrained countries. Clin Infect Dis 2003; 37 (Suppl. 1): S25-35.
[http://dx.doi.org/10.1086/375369] [PMID: 12822129]
[16]
Obirikorang C, Quaye L, Acheampong I. Total lymphocyte count as a surrogate marker for CD4 count in resource-limited settings. BMC Infect Dis 2012; 12(1): 128.
[http://dx.doi.org/10.1186/1471-2334-12-128] [PMID: 22676809]
[17]
Spacek LA, Griswold M, Quinn TC, Moore RD. Total lymphocyte count and hemoglobin combined in an algorithm to initiate the use of highly active antiretroviral therapy in resource-limited settings. AIDS 2003; 17(9): 1311-7.
[http://dx.doi.org/10.1097/00002030-200306130-00005] [PMID: 12799552]
[18]
Badri M, Wood R. Usefulness of total lymphocyte count in monitoring highly active antiretroviral therapy in resource-limited settings. AIDS 2003; 17(4): 541-5.
[http://dx.doi.org/10.1097/00002030-200303070-00009] [PMID: 12598774]
[19]
Kumarasamy N, Mahajan AP, Flanigan TP, et al. Total lymphocyte count (TLC) is a useful tool for the timing of opportunistic infection prophylaxis in India and other resource-constrained countries. J Acquir Immune Defic Syndr 2002; 31(4): 378-83.
[http://dx.doi.org/10.1097/00126334-200212010-00002] [PMID: 12447007]
[20]
Daka D, Loha E. Relationship between Total Lymphocyte count (TLC) and CD4 count among peoples living with HIV, Southern Ethiopia: a retrospective evaluation. AIDS Res Ther 2008; 5(1): 26.
[http://dx.doi.org/10.1186/1742-6405-5-26] [PMID: 19102769]
[21]
Akinola NO, Olasode O, Adediran IA, et al. The search for a predictor of CD4 cell count continues: total lymphocyte count is not a substitute for CD4 cell count in the management of HIV-infected individuals in a resource-limited setting. Clin Infect Dis 2004; 39(4): 579-81.
[http://dx.doi.org/10.1086/422722] [PMID: 15356826]
[22]
Angelo ALD, Angelo CD, Torres AJL, et al. Evaluating total lymphocyte counts as a substitute for CD4 counts in the follow up of AIDS patients. Braz J Infect Dis 2007; 11(5): 466-70.
[http://dx.doi.org/10.1590/S1413-86702007000500005] [PMID: 17962871]
[23]
Anastos K, Shi Q, French AL, et al. Total lymphocyte count, hemoglobin, and delayed-type hypersensitivity as predictors of death and AIDS illness in HIV-1-infected women receiving highly active antiretroviral therapy. J Acquir Immune Defic Syndr 2004; 35(4): 383-92.
[http://dx.doi.org/10.1097/00126334-200404010-00008] [PMID: 15097155]
[24]
Costello C, Nelson KE, Suriyanon V, et al. HIV-1 subtype E progression among northern Thai couples: traditional and non-traditional predictors of survival. Int J Epidemiol 2005; 34(3): 577-84.
[http://dx.doi.org/10.1093/ije/dyi023] [PMID: 15737969]
[25]
Sen S, Vyas A, Sanghi S, et al. Correlation of CD4+ T cell count with total lymphocyte count, haemoglobin and erythrocyte sedimentation rate levels in human immunodeficiency virus type-1 disease. Med J Armed Forces India 2011; 67(1): 15-20.
[http://dx.doi.org/10.1016/S0377-1237(11)80005-5] [PMID: 27365755]
[26]
Moore DM, Awor A, Downing RS, et al. Determining eligibility for antiretroviral therapy in resource-limited settings using total lymphocyte counts, hemoglobin and body mass index. AIDS Res Ther 2007; 4(1): 1.
[http://dx.doi.org/10.1186/1742-6405-4-1] [PMID: 17233896]
[27]
Akanmu AS, Akinsete I, Eshofonie AO, Davies AO, Okany CC. Absolute lymphocyte count as surrogate for CD4+ cell count in monitoring response to antiretroviral therapy. Niger Postgrad Med J 2001; 8(3): 105-11.
[PMID: 11721211]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy