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Related Experiment Videos

CD4 Lymphocyte enumeration: comparison between flow cytometry and enzyme immunoassay

P Cordiali Fei1, M Solmone, P Vanacore

  • 1Laboratory of Clinical Pathology, Istituto San Gallicano, Rome, Italy.

Cytometry
|March 15, 1995
PubMed
Summary

A new enzyme immunoassay for counting CD4 cells shows good correlation with flow cytometry in most patient groups, offering a viable alternative where flow cytometry is unavailable. However, accuracy may be affected at low CD4 counts and in patients on cyclosporin A.

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Area of Science:

  • Immunology
  • Clinical Laboratory Science

Background:

  • CD4 lymphocyte count is critical for monitoring acquired immunodeficiency syndrome (AIDS) progression.
  • Flow cytometry is the standard method for CD4 cell assessment.
  • An enzyme immunoassay (EIA) offers a potential alternative for CD4 cell counting in resource-limited settings.

Purpose of the Study:

  • To comparatively evaluate the accuracy of a commercial enzyme immunoassay against flow cytometry for CD4 cell enumeration.
  • To assess the EIA's performance across diverse patient populations including healthy individuals, HIV-infected patients, and those with autoimmune diseases or psoriasis.

Main Methods:

  • Comparative analysis of CD4 lymphocyte counts obtained via flow cytometry and the enzyme immunoassay.
  • Study included healthy subjects (N=30), HIV-infected individuals (N=80), patients with autoimmune diseases (N=28), and psoriasis patients (N=18).

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  • Specific subgroup analysis for psoriatic patients treated with cyclosporin A (N=7).

    • Main Results:

    • Strong correlations were observed between EIA and flow cytometry in healthy subjects (R=0.88), HIV-infected individuals (R=0.91), and autoimmune disease patients (R=0.82).
    • A significant correlation was found in psoriasis patients (R=0.76), but not in those treated with cyclosporin A (R=0.05).
    • Potential overestimation of CD4 cell numbers by EIA at low counts due to eluted CD4 antigen or soluble CD4.

    Conclusions:

    • The enzyme immunoassay is a reliable alternative to flow cytometry for CD4 cell counting in various clinical settings, particularly for HIV monitoring.
    • Caution is advised when interpreting EIA results at low CD4 lymphocyte levels and in psoriatic patients on cyclosporin A therapy.
    • Further validation may be needed for specific patient populations or therapeutic interventions impacting CD4 antigen expression.