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Related Experiment Videos

Absolute lymphocyte count as a predictor of CD4 count

N I Shapiro1, D J Karras, S H Leech

  • 1Division of Emergency Medicine, Temple University School of Medicine, Philadelphia, PA, USA. NSHAPIR01@AOL.COM

Annals of Emergency Medicine
|September 16, 1998
PubMed
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The absolute lymphocyte count (ALC) can predict low CD4 counts, a key indicator for opportunistic infection risk. An ALC below 1,000 cells/mm³ suggests a CD4 count below 200 cells/mm³.

Area of Science:

  • Clinical immunology
  • Hematology
  • Infectious disease

Background:

  • CD4 counts are critical for assessing immune status, particularly in immunocompromised individuals.
  • Low CD4 counts increase the risk of opportunistic infections.

Purpose of the Study:

  • To evaluate the predictive value of the absolute lymphocyte count (ALC) for identifying low CD4 counts.
  • To establish thresholds of ALC for predicting CD4 counts below 200 cells/mm³.

Main Methods:

  • Retrospective analysis of 807 CD4 count and simultaneous ALC measurements from an urban university teaching hospital.
  • Statistical analysis included calculation of sensitivities, specificities, predictive values, and likelihood ratios for various ALC thresholds.

Main Results:

Related Experiment Videos

  • A strong correlation (r=.69, P<.0001) was observed between ALC and CD4 counts.
  • An ALC < 1,000 cells/mm³ predicted CD4 < 200 cells/mm³ with 67% sensitivity and 96% specificity.
  • An ALC ≥ 2,000 cells/mm³ predicted CD4 ≥ 200 cells/mm³ with 95% negative predictive value.

Conclusions:

  • A reliable relationship exists between ALC and CD4 count.
  • ALC thresholds of < 1,000 cells/mm³ and ≥ 2,000 cells/mm³ can predict CD4 counts < 200 and ≥ 200 cells/mm³, respectively.
  • These ALC criteria can aid clinicians in identifying patients at higher risk for opportunistic infections.