Absolute or total lymphocyte count as a marker for the CD4 T lymphocyte criterion for initiating antiretroviral therapy.
Absolute or total lymphocyte count as a marker for the CD4 T lymphocyte criterion for initiating antiretroviral therapy.
复制标题
绝对或总淋巴细胞计数作为开始抗逆转录病毒治疗的 CD4 T 淋巴细胞标准的标志。
DOI：
10.1097/00002030-200304110-00019
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Kahn,James
中科院分区：
文献类型：
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作者：
Jacobson,MarkA;Liu,Lea;Khayam-Bashi,Hassan;Deeks,StevenG;Hecht,FrederickM;Kahn,James
We analysed simultaneous CD4, absolute (ALC) and total (TLC) lymphocyte counts of 2057 patients. ALC of 1750 cells/μl or less optimized sensitivity and specificity for predicting CD4 cell counts less than 350 cells/μl. ALC sensitivity/specificity tended to be higher for blacks, patients under 50 years old, and patients with higher plasma HIV-RNA values. TLC values slightly higher than ALC provided virtually identical results. ALC or TLC may be helpful in deciding when to initiate antiretroviral therapy in resource-poor settings.As highly active antiretroviral therapy (HAART) is now becoming available to large populations of HIV-infected patients in resource-poor countries, resource-appropriate markers need to be identified for clinicians to use in deciding when to initiate HAART. Previous studies suggested the absolute lymphocyte count (ALC) or total lymphocyte count (TLC, ie ALC plus all large lymphocytes such as lymphoblasts or reactive lymphocytes) might be useful in identifying patients who would benefit from initiating prophylaxis for AIDS-related opportunistic infections [1–3]. We therefore conducted a study to determine whether ALC or TLC has the potential clinical utility in identifying patients who would benefit from HAART, analysing sensitivity and specificity over a range of ALC and TLC values for a CD4 cell count of either less than 350 or less than 200 cells/μl (values chosen because of the consensus that HAART should be deferred until a patient's CD4 cell count drops below 350 cells/μl, but should be initiated before the CD4 cell count drops below 200 cells/μl)[4–10]. We examined how factors not previously examined (sex, race, age, HIV viral load, antiretroviral treatment) might affect the performance of ALC or TLC as a surrogate for absolute CD4 T lymphocyte counts.
