EVALUATION OF TOTAL LYMPHOCYTE COUNT, BODY MASS INDEX, HAEMOGLOBIN AND ALBUMIN LEVELS AS LOW COST SURROGATE MARKERS FOR CD4 COUNTS IN ASSESSING DISEASE PROGRESSION IN HIV/AIDS- A DESCRIPTIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 76
Abstract
BACKGROUND Infection with HIV progresses to AIDS at different rates in different individuals with a spectrum varying from rapid progression to long-term non-progression. Thus, it becomes essential to have tests which accurately assesses the stage of the disease as well as predicting the progression. The single best predictor so far used being the Plasma HIV RNA load and the CD4+ T cell count. Plasma viral load testing with its reliance on sophisticated laboratories and patented PCR kits has also been extremely challenging to scale up in resource limited settings. Hence, the need for evaluation of surrogate markers for identifying disease progression. The aim of this study is to evaluate the effectiveness of Total Lymphocyte Count, Body Mass Index, Haemoglobin and Albumin levels as low-cost surrogate markers in predicting disease progression in HIV/AIDS. MATERIALS AND METHODS This is a Descriptive Study; 100 patients fulfilling the above-mentioned criteria were included in the study. Their presenting Total Lymphocyte Count, Body Mass Index, Haemoglobin and Albumin levels were correlated with their CD4 counts and to their clinical staging. The feasibility of using these parameters as low cost surrogate markers instead of CD4 count in assessing the progression of the disease was finally evaluated. The statistical method used for analysis was Spearman’s Rho rank correlation test. Analysis was done using IBM SPSS statistical software Version 20.0. RESULTS A total of 100 patients were included into the study. Patients in stage I disease had a mean CD4 count of 665 [SD 219.82]. There was a significant drop in the mean CD4 count in the stage II disease to 298 [SD 74.54]. There was still further drop in the CD4 count in stages III and IV to 195 [SD 118.03] and 146 [SD 85.09] respectively, proving the well-known fact that fall in CD4 count is a marker of disease progression in HIV. The range of TLC in our study was between 906 and 4256. Patients in the stage I disease had a mean TLC of 3246 [SD 524.98]. There was a significant drop in the mean TLC in the stage II disease to 2053 [SD 362.04]. There was still further drop in the TLC in stages III and IV to 1460 [SD 346.85] and 1343 [SD 310.00], respectively. There is strong positive correlation between CD4 count and TLC, HB, BMI and Serum Albumin. CONCLUSION HIV infection is common in third-to-fifth decade of life with higher prevalence in males. TLC together with BMI, HB and Serum Albumin levels are sensitive surrogate markers for CD4 counts in predicting the progression of HIV/AIDS.
Authors and Affiliations
Daranendran Chellappa, Subramanian Vadivel
Keywords
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- EP ID EP267470
- DOI 10.14260/Jemds/2017/1180
- Views 65
- Downloads 0
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