Use of total lymphocyte count to predict absolute CD4 count in HIV-seropositive cases

We conducted an observational study to assess the use of total lymphocyte counts (TLC) alone and along with hemoglobin (Hb) as a predictor of CD4 count. A total of 103 antiretroviral therapy (ART)-naive HIV-1-infected patients were enrolled and divided in 2 groups (with CD4 count <200 cells/mm(3) and CD4 count ≥200 cells/mm(3)). The TLC and Hb were performed by automatic full digital cell counter. CD4 count was determined by flow cytometry. Among the World Health Organization (WHO) clinical stages 2 and 3, in the cases with CD4 count <200 cells/mm(3), 70.4% cases had TLC ≤1200 cells/mm( 3), whereas 63% cases had TLC ≤1200 cells/mm(3) + Hb ≤12 g/dL. In the cases with CD4 count >200 cells/mm(3), 2% cases had TLC ≤1200 cells/mm(3), whereas adding Hb ≤12 g/dL with TLC ≤1200 cells/mm(3), none of the cases would require initiation of ART. TLC + Hb can be used to treat all HIV-infected patients with WHO stages 2 and 3 who have a TLC <1200 cells/mm(3) + Hb ≤12 g/dL and to limit CD4 counts to patients who are symptomatic but have TLC + Hb values other than TLC <1200 cells/mm(3) + Hb ≤12 g/dL.