Evaluation of the probability of using total lymphocyte count as an alternative to CD4 count in initiation of art

Abstract

Measurement of CD4+ T cell count in the diagnosis of HIV in a resource-constrain settings is often difficult due to high cost of equipments, reagents, and demand for trained personnel. There is need for relatively cost effective technique with good Prognosis for Human Immunodeficiency Virus (HIV) infection. Two hundred and fourty four (244) HIV seropositive (tests) and fifty (50) HIV seronegative individuals (controls) were analyzed for CD4 count and TLC. The result of the study was analyzed using SPSS 14, the mean + SEM 930 + 43 cells/ìl (CD4 count) and 2026 + 75 cells/mm3 Total Lymphocyte Count (TLC) in control and 196 + 8.0 cells/ìl (CD4 count) and 1969 + 66 cells/mm3 (TLC) in Test group were obtained. There was significant difference between the values of CD4 count recorded in Test (196 + 8.0 cells/ì) when compared with the value recorded in Control (930 + 43 cells/ìl) (p<0.01), but there was no significant difference in the values of TLC recorded in Test (1969 + 66 cells/mm3) when compared with the values recorded in the control (2026 + 75 cells/mm3) (p<0.01). This is due to the fact that CD4+T lymphocyte are specifically
targeted by HIV which results in linear reduction in CD4 count not the whole population of Tlymphocytes and B-lymphocytes. A spearman’s correlation study was done between the CD4 counts and TLC, indicated a slightly positive correlation (r= 0.586) among the test individuals and strong
positive correlation in the control (r = 0.739). It could be concluded that  total lymphocyte count can not be used alone as an alternative to CD4 count in initiating ART, but in conjunction with clinical sign and symptoms.

Keywords: Human immunodeficiency virus, CD4 count, Total lymphocyte count, and Antiretroviral therapy.