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At least 19 recordsLinked to original sources
PubMed1992

The relationship of total lymphocyte count to CD4 lymphocyte counts in patients infected with human immunodeficiency virus.

A simple, inexpensive alternative to CD4 counts would facilitate the management of asymptomatic and early symptomatic patients with HIV infection. In this report, a high correlation was found between CD4 counts and total lymphocyte counts calculated from complete blood counts in a cohort of ambulatory HIV-infected patients. Using these data, patients with CD4 counts above and below 500 cells/mm3, 200 cells/mm3, and those with and without symptoms can be identified with a high degree of predictive value. The availability and lower cost of lymphocyte counts make them an attractive alternative to CD4 counts in managing asymptomatic and early symptomatic patients with HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Total lymphocyte count and subpopulation lymphocyte counts in relation to dietary intake and nutritional status of peritoneal dialysis patients.

Dietary deficiency causes abnormalities in circulating lymphocyte counts. For the present paper, we evaluated correlations between total and subpopulation lymphocyte counts (TLC, SLCs) and parameters of nutrition in peritoneal dialysis (PD) patients. Studies were carried out in 55 patients treated with PD for 22.2 +/- 11.4 months. Parameters of nutritional status included total body mass, lean body mass (LBM), body mass index (BMI), and laboratory indices [total protein, albumin, iron, ferritin, and total iron binding capacity (TIBC)]. The SLCs were evaluated using flow cytometry. Positive correlations were seen between TLC and dietary intake of niacin; TLC and CD8 and CD16+56 counts and energy delivered from protein; CD4 count and beta-carotene and monounsaturated fatty acids 17:1 intake; and CD19 count and potassium, copper, vitamin A, and beta-carotene intake. Anorexia negatively influenced CD19 count. Serum albumin showed correlations with CD4 and CD19 counts, and LBM with CD19 count. A higher CD19 count was connected with a higher red blood cell count, hemoglobin, and hematocrit. Correlations were observed between TIBC and TLC and CD3 and CD8 counts, and between serum Fe and TLC and CD3 and CD4 counts. Patients with a higher CD19 count showed a better clinical-laboratory score, especially less weakness. Patients with a higher CD4 count had less expressed insomnia. Quantities of ingested vitamins and minerals influence lymphocyte counts in the peripheral blood of PD patients. Evaluation of TLC and SLCs is helpful in monitoring the effectiveness of nutrition in these patients.

Antigens, CD↗
PubMed2005

Total lymphocyte count and subpopulation lymphocyte count in relation to blood bicarbonate concentration in peritoneal dialysis patients.

Metabolic acidosis negatively influences dietary intake, increases protein catabolism, and deteriorates nutritional status. In the present study, we evaluated in peritoneal dialysis (PD) patients whether parameters of blood acid-base equilibrium influence total and subpopulation lymphocyte counts (TLC, SLCs), which are markers of the immunologic and nutritional status of dialyzed patients. Studies were carried out in 55 patients, mean age 50.9 +/- 12.4 years, treated with PD for a mean of 22.2 +/- 11.4 months. Parameters of blood acid-base equilibrium were measured simultaneously with evaluation of TLC and SLCs. (Antigens CD3, CD4, CD5, CD8, CD19, CD16+56 were determined using flow cytometry.) The study patients showed compensated metabolic acidosis (pH: 7.40 +/- 0.04; HCO3-: 22.9 +/- 2.4 mmol/L). Statistical analysis revealed significant (p < 0.05) positive correlations of bicarbonate blood concentration and base excess with TLC and with CD3, CD5, and CD8 cell counts, but not with CD19 and CD16+56 cell counts. The CD4 cell count correlated only with blood bicarbonate level. Patients on PD who show better correction of metabolic acidosis also show higher TLC and CD3, CD4, CD5, and CD8 cell counts. The numbers of B lymphocytes (CD19) and natural killer cells (CD16+56) are not directly related to bicarbonate blood concentration, at least in the examined range.

Acid-Base Equilibrium↗
PubMed2002

[Changes in peripheral lymphocytes count in unconscious patients treated at home with Japanese herbal medicines (Hozai)].

We investigated changes in peripheral white blood cells count, lymphocytes count, and serum albumin level in five unconscious patients administered Japanese herbal medicines (Hozai). The causes of unconsciousness were intracerebral hemorrhage in 3, cerebral infarction in 1, and craniopharyngioma in 1. The administered Hozai were Hotyu-ekki-to in 4 and Jyuzen-taiho-to in 1. To assess the effect of Hozai on the immune system of unconscious patients, we investigated these parameters before and after treatment. We observed normalization of WBC counts, increase of lymphocytes count, and unchanged levels of serum albumin after Hozai treatment. These findings suggest that Hozai may improve the immunological competence of unconscious patients. One of the problems affecting unconscious patients treated at home is infectious diseases, especially respiratory infections. It is considered that improvement of their immunological competence would contribute to prevent infections. These results suggest that Hozai treatment might be useful adjuvants to support the general condition of the patients treated at home.

Aged↗
PubMed1997

Dose titration during anti-thymocyte globulin therapy: monitoring by CD3 count or total lymphocyte count?

Anti-thymocyte globulin (ATG) is extensively used for both prophylaxis and treatment of rejection episodes in renal transplantation, but it is expensive and potentially hazardous. We report the utility of therapeutic monitoring by the readily available total lymphocyte count, compared with the more complex and expensive assay of CD3 counts by flow cytometry in eight renal transplant patients receiving ATG. Aiming for an absolute CD3 count of 0.2-0.5 x 10(9)/l, it was possible to reduce the mean daily dose of ATG from the recommended 2.5 mg/kg/d to a mean of 1.6 mg/kg/d. Analysis of simultaneously taken total lymphocyte counts showed that the same dose reductions could have been made if the target for therapeutic effect had been a total lymphocyte count of < 0.3 x 10(9)/l. Anti-rejection therapy was successful in all cases, with satisfactory graft function at 6-9 months post-therapy. Lower than recommended doses of ATG proved effective prophylaxis and treatment of renal allograft rejection, with considerable cost savings. A simple protocol may be followed titrating dose against total lymphocyte count, provided it remains below 0.3 x 10(9)/l. CD3 estimation can be reserved for those times when the total lymphocyte count rises to 0.3 x 10(9)/l or above.

Antigens, CD19↗
PubMedDate not supplied

Absolute lymphocyte count as a marker for CD4 T-lymphocyte count: criterion for initiating antiretroviral therapy in HIV infected Nigerians.

BACKGROUND: Few laboratories in resource-constrained countries can afford to perform laboratory-monitoring tests required for the implementation of HIV therapy. In this case control study, we have investigated the relevance of absolute lymphocyte count as a surrogate marker for CD4 lymphocyte count as a criterion for initiating HAARTin HIV-infected Nigerians. METHODS: A total of 100 consecutive recruited HIV-infected, previously antiretroviral naive persons and 30 HIV-negative individuals blood samples were run for absolute lymphocyte and CD4 lymphocyte counts and results were compared by a model of linear regression analysis. RESULTS: An overall modest correlation was observed between absolute lymphocyte count and CD4 lymphocyte (r = 0.51) and at CD4 lymphocyte threshold relevant for clinical management of HIV-infected; <200, 200-350 and >350 cells/microL (r = 0.41, 0.30 and 0.21) respectively. Mean absolute lymphocyte count of 1.60 +/- 0.77 x 10(9)/L, 1.88 +/- 1.11 x 10(9)/L and 2.04 +/- 0.54 x 10(9)/L was equivalent respectively to CD4 of <200, 200-350 and >350 cells/microL. CONCLUSIONS: This study indicates a modest correlation between absolute and CD4 lymphocyte counts of HIV-infected Nigerians and at CD4 lymphocyte count threshold significant for clinical management of HIV-infected. Absolute lymphocyte count can become a minimal inexpensive alternative to CD4 lymphocyte count in conjunction with WHO staging and clinical status of patient in determining the optimal time to initiate therapy particularly in resource limited settings where other expensive methods of CD4 enumeration are unavailable.

Adolescent↗
PubMed2006

Monitoring antiretroviral therapy in HIV/AIDS patients in resource-limited settings: CD4 counts or total lymphocyte counts?

OBJECTIVE: In order to improve the monitoring of disease progression and therapeutic effectiveness in the management of HIV/AIDS in a resource-limited setting, this study was carried out to establish a correlation between total lymphocyte counts (TLC) and CD4 lymphocyte counts in HIV-1 infected/AIDS adults in Yaoundé, Cameroon. METHODS: Full blood counts, differential white, and CD4 counts were measured in 149 patients using standard methods. The correlation coefficient established correlation between values. Sensitivity, specificity, and positive predictive values were calculated as required. RESULTS: The mean TLC, CD4 count, and CD4% as well as CD4/CD8 ratios were 1.932+/-0.895 x 10(9)/L, 268+/-183 cells/mm(3), 14.51+/-15.9%, and 0.34+/-0.25, respectively. Only a weak correlation was observed between TLC and CD4 counts (r=0.41, p=0.05). As a predictor of CD4 count, TLC cut-offs <2.0 and <1.0 x 10(9)/L were unable to predict these values reliably, but showed that at TLC cut-offs of <1.0 x 10(9)/L there was a high chance of CD4 counts being under 200 cells/mm(3). CONCLUSIONS: These data suggest that TLC are of limited value in predicting CD4 counts and should not be substituted for CD4 counts whenever possible. However, TLC may be reliably used in designing algorithms and programs for initiating patient management and follow-up in this setting.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Oral candidiasis as a clinical marker related to viral load, CD4 lymphocyte count and CD4 lymphocyte percentage in HIV-infected patients.

BACKGROUND: High viral load is currently considered to be one of the main indicators of the progression of HIV-induced immunodepression, but few studies have analysed its relationship to the presence of oral candidiasis (OC). The aim of this cross-sectional study is to analyse the relationship between viral load, total CD4 lymphocyte count, and percentage of CD4 lymphocytes to the occurrence of OC. METHODS: The present cross-sectional study included 156 HIV-infected patients seen at a clinic for sexually transmitted diseases and HIV. We assessed the presence or absence of OC, and microbiological samples were obtained from the palatine mucosa and dorsal tongue for a smear stained with KOH (potassium hydroxide) and culture on Sabouraud's dextrose agar in all patients. Viral load was determined by quantification of viral RNA in peripheral blood with a minimum detectable level of 500 RNA copies/ml. CD4+ counts/CD4+ percentage were categorized as <200/<14%, 200-499/14-28%, and >500/>29%, and HIV viral loads were categorized as <500, 500-10,000, >10,000 copies/ml. RESULTS: Thirty-eight percent (37.8%) of the patients had OC. Patients with CD4+ lymphocyte counts below 200 x 10(6)/l and CD4+ percentages below 14% showed a significantly higher frequency of OC (57.9% and 48.0%, respectively). Patients with a viral load over 10,000 copies/ml also had OC more frequently (44.8%). In the multiple logistic regression analysis, OC showed a statistically significant association with high viral load [>10,000 vs <500, odds ratio (OR)=11.4], low percentage of CD4+ lymphocytes (<14% vs >28%, OR=5), and injection drug use (IDU vs heterosexual transmission, OR=10.2). In HIV-infected patients, high viral load was associated with more frequent OC, regardless of CD4+ lymphocyte level. CONCLUSIONS: These findings suggest that oral candidiasis could be a useful clinical marker of patients with high viral load. In view of these results, emphasis should be placed on the importance of systematic examination of the oral cavity in all medical follow-up examinations of HIV-infected patients.

AIDS-Related Opportunistic Infections↗
PubMed1991

[Influence of therapy with glucocorticosteroids on clinical status, t4 lymphocyte count and t4/t8 lymphocyte ratio in people infected with AIDS].

The influence of glucocorticosteroids (GKS) therapy on clinical status, T4 lymphocyte count in peripheral blood and T4/T8 lymphocyte ratio was investigated in five HIV infected patients: two were asymptomatic, while three had clinically overt disease. The reasons for GKS therapy were: thrombocytopenia in two patients, pancytopenia in two and sepsis with severe endocarditis in one. No influence of GKS on the clinical course of HIV infection was observed. The prospective determinations of T4 lymphocyte count and T4/T8 lymphocyte ratio were relatively constant in two cases, in one case increased and in two patients, one of whom had AIDS, a decrease in both parameters was observed. It seems that GKS therapy does not seriously influence the course of HIV infection in most patients and can be instituted without risk of severe worsening of the immune status.

Adrenal Cortex Hormones↗
PubMed1994

[Validity of an ELISA test for CD4+ T lymphocyte count and validity of total lymphocyte count in the assessment of immunodeficiency status in HIV infection].

A newly available commercial ELISA (TRAx CD4, T Cell Diagnostics USA) for enumerating CD4+ T lymphocytes has been evaluated with blood samples of 105 HIV seropositive and 6 seronegative subjects. Results from the flow cytometric analysis were used as reference. The sensitivity and specificity of the ELISA to identify HIV seropositive subjects having less than 200 CD4+ T lymphocytes/microliters were assessed and studied using the ROC curve. The reproducibility of the ELISA test was analyzed on 40 samples. The results of the ELISA correlated well with these of the flow cytometric analysis (r = 0.79, p < 0.001). However, the ELISA test tends to overestimate the true CD4 count in HIV seropositives. This overestimation could not be explained by the aspecific contribution of monocytic CD4. The threshold for identifying HIV seropositive subjects with less than 200 CD4+ T lymphocytes with a maximum sensitivity and specificity was determined with ROC curve and equalled 400 cell equivalents with the ELISA (sensitivity and specificity were equal to 80%) and 1,450 lymphocytes/microliters with the total absolute lymphocyte count (sensitivity and specificity were equal to 75%). Using this curve, a threshold of 300 cell equivalents for the ELISA test and of 1,100 lymphocytes/microliters for the absolute lymphocyte count was shown to maximize the specificity (> 95%) without a significant loss of sensitivity.

CD4-Positive T-Lymphocytes↗
PubMed2004

Infused peripheral blood autograft absolute lymphocyte count correlates with day 15 absolute lymphocyte count and clinical outcome after autologous peripheral hematopoietic stem cell transplantation in non-Hodgkin's lymphoma.

Absolute lymphocyte count at day 15 (ALC-15) after autologous peripheral blood hematopoietic stem cell transplantation (APHSCT) is an independent prognostic factor for survival in non-Hodgkin's lymphoma (NHL). Factors affecting ALC-15 remain unknown. We hypothesized that dose of infused autograft lymphocytes (A-ALC) directly impacts upon ALC-15. A total of 190 consecutive NHL patients received A-ALC between 1993 and 2001. The primary end point was correlation between A-ALC and ALC-15. A strong correlation was identified (r=0.71). A higher A-ALC was infused into patients achieving an ALC-15 > or =500/microl vs ALC-15 <500/microl (median of 0.68 x 10(9)/kg (0.04-2.21 x 10(9)/kg), vs 0.34 x 10(9)/kg (0.04-1.42 x 10(9)/kg), P<0.0001). The median follow-up for all patients was 36 months (maximum of 109 months). The A-ALC threshold was determined at 0.5 x 10(9)/kg. The median overall survival (OS) and progression-free survival (PFS) times were longer in patients who received an A-ALC >/=0.5 x 10(9)/kg vs A-ALC <0.5 x 10(9)/kg (76 vs 17 months, P<0.0001; 49 vs 10 months, P<0.0001, respectively). Multivariate analysis demonstrated A-ALC to be an independent prognostic indicator for OS and PFS. These data support our hypothesis that ALC-15 and survival are dependent upon the dose of infused A-ALC in NHL.

Adult↗
PubMed2004

The search for a predictor of CD4 cell count continues: total lymphocyte count is not a substitute for CD4 cell count in the management of HIV-infected individuals in a resource-limited setting.

Total lymphocyte count (TLC) has been recommended as a substitute for CD4 cell count for the management of HIV-infected individuals living in resource-limited settings. To confirm this, 151 TLCs and CD4 cell counts were obtained from 109 patients who had not yet started treatment and analyzed. CD4 cell counts of <200 cells/mm3 were found in 42 cases (37.8%) with TLCs of > or =1200 cells/mm3. Thus, 1 in 3 individuals would have been deprived of needed treatment. Therefore, in this setting, TLC is not a reliable predictor of CD4 cell count in HIV-infected individuals.

Adult↗
PubMed2005

Predicting CD4 count using total lymphocyte count: a sustainable tool for clinical decisions during HAART use.

Understanding the total lymphocyte count (TLC)-CD4 count relationship could aide design predictive instruments for making clinical decisions during antiretroviral therapy, especially in underserved resource-poor settings. We performed multiple regression analyses to assess the prediction of CD4 count using TLC on 771 participants with 4,836 visits. In linear and logistic regression TLC, hemoglobin, gender, history of AIDS, and weight predicted CD4 count and CD4 < 200, respectively, before and after highly active antiretroviral therapy (HAART) use. On HAART, the adjusted odds ratios (OR) for TLC < 1500 (optimal TLC cutoff) were 5.1 (95%CI 4.0, 6.5; P < 0.001), and off HAART, 4.6 (95%CI 3.4, 6.2: P < 0.001) with high predictive power. TLC predicts CD4 count and CD4 < 200 cells/microL well during HAART. Including the additional factors improves performance. TLC is simple and inexpensive and can be used in many ways to develop clinical decision-making tools in underserved resource-poor settings during HAART therapy.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Total lymphocyte count of 1200 is not a sensitive predictor of CD4 lymphocyte count among patients with HIV disease in Kampala, Uganda.

INTRODUCTION: Total Lymphocyte Count (TLC) has been found to be an inexpensive and useful marker for staging disease, predicting progression to AIDS and death and monitoring response to ART. However, the correlation between TLC and CD4 has not been consistent. Access to HAART is expanding in Kampala, Uganda, yet there are no published data evaluating the utility of TLC as inexpensive surrogate marker of CD4 cell count to help guide therapeutic decisions. OBJECTIVE: To evaluate clinical illnesses and total lymphocyte count (TLC) as surrogate markers of the CD4 cell count in HIV infected persons being considered for ART. METHODS: A total of 131 patients were enrolled and evaluated by clinical assessment, TLC and CD4 count. Clinical illnesses and TLC dichotomized at various cut-point values were used to determine the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) for the diagnosis of CD4 count <200 cells/mm 3 among 100 participants fulfilling criteria for WHO clinical stage 2 and 3. RESULTS: A strong correlation was observed between TLC and CD4 (r = 0.73, p<0.0001). For all clinical syndromes, except pulmonary tuberculosis, the positive predictive values (PPV) for a CD4 count <200 cells/mm 3 were high (>80%) but the negative predictive values (NPV) were low. Using the WHO recommended TLC cut-off of 1200 cells/mm 3 to diagnose a CD4 less than 200 cells/mm 3 , the PPV was 100%, and the NPV was 32%. CONCLUSION: Our data showed a good correlation between TLC and CD4 cell count. However, the WHO recommended TLC cut-off of 1200 did not identify the majority of WHO stage 2 and 3 patients with CD4 counts less than 200 cells/mm 3 . A more rational use of TLC counts is to treat all patients with WHO stage 2 and 3 who have a TLC <1200 and to limit CD4 counts to patients who are symptomatic but have TLC of >1200.

Adult↗