Predictors of CD4 Count in HIV Infected Patients

This study “PREDICTORS OF CD4 COUNT IN HIV INFECTED PATIENTS” , was conducted in 100 HIV positive patients who were attended the ART medical centre in Govt. Rajaji Hospital, Madurai from June 08 to June 2009. In our study 100 patients were randomly selected of which 66% were males and 34% were females. About 74% were in age group between 21- 40 years showed the prevalence of disease in reproductive age group. In all the patients various clinical and inexpensive laboratory measures such as WHO clinical Staging ,BMI ,Total Lymphocyte Count (TLC),haemoglobin ,platelet count, ESR, S. Albumin were done and correlated with CD4 count .It was analysed that these parameters may be used as a surrogate marker for CD4 count to initiate ART and to monitor therapy. WHO staging III and IV had sensitivity of 93% and specificity of 25% in predicting CD4 count < 200 cells/μL and it showed a significant correlation with CD4 count. TLC <1200 cells/mm3 had sensitivity of 100% and specificity of 95% in predicting CD4 count <200 cells/μL and it showed a statistically significant correlation with CD4 count. BMI<18.5kg/m2,Haemoglobin<11g%,Platelets<150000cells/mm3, ESR >30mm/hr and s.albumin<3.5g/dl showed a statistically significant correlation with CD4 count but they were less sensitive and less specific when compared to TLC or WHO staging. Therefore TLC is most sensitive and specific best predictor of CD4 count <200 cells/μL. WHO clinical staging is a good sensitive test in predicting CD4 count less than 200 cells/μL. TLC when combined with WHO staging or Anaemia, specificity in predicting CD4 count <200 cells/μL increases, than using staging or anaemia alone. Although the CD4 count has become the “gold standard”, TLC < 1200 cells/mm³ or TLC along with WHO staging or anaemia may be used as a surrogate marker for CD4 count