Related Experiment Video
Updated: Jun 24, 2026
Standardization of Transfer across Labs between Flow Cytometers for Detection of Lymphocytes in Japanese Encephalitis Vaccinated Children
Published on: February 10, 2023
Establishment of T-lymphocyte subset reference intervals in a healthy adult population in Chennai, India
K G Murugavel1, P Balakrishnan, J Mohanakrishnan
1YRG Centre for AIDS Research & Education, Voluntary Health Services Hospital Campus Rajiv Gandhi Salai, Chennai India. murugavel@yrgcare.org
Insights
This study establishes local reference values for CD4+ T-lymphocyte counts in healthy South Indian adults. Findings reveal significant differences between men and women, crucial for accurate HIV monitoring.
Area of Science:
- Immunology
- Clinical Diagnostics
- Public Health
Background:
- CD4+ T-lymphocyte counts are vital for HIV disease monitoring and treatment response.
- Existing CD4+ T-lymphocyte reference values often lack local applicability, potentially impacting patient care.
- Establishing local reference ranges is essential for accurate diagnostic interpretation.
Purpose of the Study:
- To determine reference values for CD4+ T-lymphocyte subsets in a healthy South Indian adult population.
- To compare CD4+ T-lymphocyte counts and ratios between genders.
- To investigate the influence of age on these immunological parameters.
Main Methods:
- A cross-sectional study was conducted with 213 HIV-1/2 seronegative adults in Chennai, India.
- Whole blood specimens were analyzed for CD4+ and CD8+ T-lymphocyte counts and hematological parameters.
- Statistical analysis was performed to establish reference ranges and compare demographic groups.
Main Results:
- Established CD4+ T-lymphocyte reference ranges: Men (383-1347 cells/µL), Women (448-1593 cells/µL).
- Women exhibited significantly higher absolute CD4+ T-lymphocyte counts and CD4+:CD8+ ratios compared to men (P<0.001).
- Age showed minimal influence, except on the CD4+:CD8+ ratio in individuals over 45 years.
Conclusions:
- The study provides crucial, localized CD4+ T-lymphocyte reference values for the South Indian population.
- Gender-specific reference ranges are recommended for more precise HIV disease management.
- Further research with larger sample sizes is needed to refine HIV staging based on these local norms.
Abstract:
Estimation of CD4+ T-lymphocytes continues to be an important aspect for monitoring HIV disease progression and response to antiretroviral therapy. Most of the diagnostic laboratories often rely on western text books for CD4+ T-lymphocyte reference values, which could, often be unreliable for usage in local settings. Therefore, we attempted to establish the reference values for T-lymphocyte subsets among healthy adults in a cross-sectional study carried out at the YRG Centre for AIDS Research and Education (YRG CARE) in Chennai, south India, in 213 (84 female and 129 male) healthy, HIV-1/2 seronegative adults as volunteers. Whole blood specimens were processed for CD4+, CD8+ T-lymphocyte estimation and haematological parameters. The established range of CD4+ T-lymphocyte counts for men and women were 383-1347 cells/microl (mean 865 and median 845 cells/microl) and 448-1593 cells/microl (mean 1021 and median 954 cells/microl), respectively. Women had significantly higher absolute CD4+ Tlymphocyte counts (P<0.001) and CD4+:CD8+ T-lymphocyte ratio as compared to men. The established normal range of CD4+ T-lymphocyte % was 21-59 (mean 40.2 and median 40.1). The influence of age was not observed in any of the parameters except CD4+/CD8+ T-lymphocyte ratio with the >45 yr age group. Further studies with greater sample size may be required to define the staging of HIV disease in relation to the normal CD4 T-lymphocyte count in the general population.
