CORRELATION OF ABSOLUTE LYMPHOCYTE COUNT (ALC) WITH CD4 COUNT IN HIV POSITIVE PATIENTS AT A TERTIARY CARE HOSPITAL

SATYANARAYANA N.¹, ANIL M.², SANJEEV S.G.³, RAVI R.⁴, DEEPAK N.^5
1Department of General medicine, ESIC-MC & PGIMSR, Rajajinagar, Bangalore-560 010, Karnataka, India.
²Department of General Medicine, ESIC-MC & PGIMSR, Rajajinagar, Bangalore- 560 010, Karnataka, India.
³Department of General Medicine, ESIC-MC & PGIMSR, Rajajinagar, Bangalore-560 010, Karnataka, India.
⁴Department of General Medicine, ESIC-MC & PGIMSR, Rajajinagar, Bangalore-560 010, Karnataka, India.
⁵Department of General medicine, ESIC-MC & PGIMSR, Rajajinagar, Bangalore-560 010, Karnataka, India.

Received : 26-11-2013     Accepted : 18-12-2013     Published : 30-12-2013
Volume : 1     Issue : 2       Pages : 34 - 37
World Res J Crit Care 1.2 (2013):34-37

<i>Background:</i> HIV infection produces profound defects in the cell mediated and humoral immunity. The virus preferentially attacks CD4 lymphocytes leading to progressive decrement in their number. Depletion of CD4 cell count is a hallmark of disease progression in HIV. In HIV positive patients CD4 count guides to decide about the timing of initiation of antiretroviral therapy (ART) and for prophylaxis of opportunistic infections. There is a need to evaluate other less expensive surrogate markers like absolute lymphocyte count (ALC). WHO recommends absolute lymphocyte count (ALC) of ≤1200/μL can substitute CD4 cell count of ≤200/μL in resource-constrained countries throughout the World. As highly active antiretroviral therapy (HAART) is now becoming available to large populations of HIV-infected patients in resource-poor countries, resource-appropriate markers need to be identified for clinicians to use in deciding when to initiate HAART. Previous studies suggested that the absolute lymphocyte count (ALC) or total lymphocyte count (TLC, i.e. ALC plus all large lymphocytes such as lymphoblast’s or reactive lymphocytes) might be useful in identifying patients who would benefit from initiating prophylaxis for AIDS-related opportunistic infections. ALC or TLC may be helpful in deciding when to initiate antiretroviral therapy in resource-poor settings. <i>Objectives:</i> To correlate absolute lymphocyte count (ALC) with CD4 counts in HIV positive patients. <i>Methods:</i> This study was conducted in Department of General medicine, ESIC-MC & PGIMSR, Rajajinagar, and Bangalore. 100 HIV positive patients were included in the study.CD4 counts were detected by flow cytometry. Absolute lymphocyte count was correlated with CD4 count. <i>Results:</i> Out of 100 patients, 60% patients had ALC <1000/cmm and 40% patients had >1000/cmm Absolute Lymphocyte Counts of 609.64±277.03/µl and 702.38±311.83 cells/µl showed observations similar to CD 4 counts of <100 cells/µl and <200 cells/µl respectively. The P value was highly significant. 46% patients had CD4 count of less than 200/cmm and 54% patients had >200/cmm. CD4 count is significantly associated with ALC with P=0.023*.