Study of correlation between clinical profile, CD4 count and total lymphocyte count in HIV infected patients at rural tertiary care institute

Background: India is a country with low HIV prevalence, yet it has the third largest number of people living with HIV/AIDS. Availability of antiretroviral medications is improving, making it is important to develop feasible strategies for the management of antiretroviral therapies in resourcelimited settings. Aim and objectives: To study clinical profile of HIV infected patients with special respect to total lymphocyte count (TLC) and CD4 count and study the correlation between Total Lymphocyte count (TLC) and CD4 count in HIV infected patients. Materials and methods: An observational study was conducted on patients admitted in general medicine ward at the tertiary care hospital, fulfilling inclusion and exclusion criteria, for duration of 24 months. The detailed history and examination findings of the patients were recorded. To analyse the data we used statistical software SPSS 16.0 was used. Results: Fever was the most common symptom reported. CD4 counts corresponded to various opportunistic infections. The Pearson correlation of TLC with CD4 counts was 0.388 i.e. moderate correlation at p<0.05 (0.005) and this showed the statistical high significance between TLC and CD4 count. Conclusion: TLC is a widely available and inexpensive parameter, which can be used in place of CD4 count, for monitoring immune status in HIV infected individuals. TLC values may be useful, but less sophisticated and less costly methods of determining CD4 counts such as microvolume Siddheshwar V. Birajdar, Sanjay S. Chavan, Deepak R. Patil. Study of correlation between clinical profile, CD4 count and total lymphocyte count in HIV infected patients at rural tertiary care institute. IAIM, 2018; 5(2): 135-140. Page 136 fluorimetry and ELISA techniques be evaluated and made available for use in resource-limited settings

Instant Nutritional Assessment (INA) in Children with Protein Energy Undernutrition (PEU).

Objective: PEM is a significant nutritional disorder in India. The aim of this study was to assess the severity of the disorder and make a quick nutritional assessment in the patients using serum albumin, total cholesterol and lymphocyte count as the laboratory parameters. The study also aimed at correlating these biochemical parameters with physical parameters. Materials and Methods: 42 clinically undernourished children in the age group of 2-5yrs were enrolled for the study. Their age and body weight were noted and the subjects were accordingly grouped under Grade 1, 2 or 3 malnutrition as per Gomez’ classification. Serum Albumin, total lymphocyte count and total cholesterol values of these cases were noted. Depending on the values obtained, the subjects were grouped into 3 categories – mild, moderate and severe malnutrition. Physicalparameters were correlated with the biochemical parameters. Results: Pearson’s correlation test results showed a significant positive correlation between Grade 1&mild malnutrition; Grade 2&moderate malnutrition; and Grade III & severe malnutrition. Conclusion: We conclude that serum albumin, cholesterol and total lymphocyte count correlate significantly with physical parameters. They are reliable parameters that can be used not only to assess severity of undernutrition but they also provide more informationabout the nutritional status such as protein and lipid reserves in the body and immune status of the individual.

Correlation Analysis on Total Lymphocyte Count and CD4 Count in HIV-infected Patients: A Retrospective Evaluation / 华中科技大学学报（医学）（英德文版）

CD4 count is the standard method for determining eligibility for highly active antiretroviral therapy (HAART) and monitoring HIV/AIDS disease progression,but it is not widely available in resource-limited settings.This study examined the correlation between total lymphocyte count (TLC) and CD4 count of HIV-infected patients before and after HAART,and assessed the thresholds of TLC for making decisions about the initiation and for monitoring HAART.A retrospective study was performed,and 665 HIV-infected patients with TLC and CD4 count from four counties (Shangcai,Queshan,Shenqiu and Weishi) were included in the study.Pearson correlation and receiver operating characteristic (ROC) were used.TLC and CD4 count after HAART was significantly increased as compared with pre-HAART (P＜0.01).An overall positive correlation was noted between TLC and CD4 count (pre-HAART,r=0.73,P=0.0001; follow-up HAART,r=0.56,P=0.0001).The ROC curve between TLC and CD4 count showed that TLC ≤ 1200 cells/mm3 could predict CD4 ＜ 200 cells/mm3 with a sensitivity of 71.12％,specificity of 66.35％at pre-HAART.After 12-month HAART,the optimum prediction for CD4 count ＜ 200 cells/mm3 was a TLC ≤ 1300 cells/mm3,with a sensitivity of 63.27％,and a specificity of 74.84％.Further finding indicated that TLC change was positively correlated to CD4 change (r=0.77,P=0.0001) at the time point of 12- month treatment,and the best prediction point of TLC change for CD4 increasing was 135 cells/mm3.TLC and its change can be used as a surrogate marker for CD4 count and its change of HIV-infected individuals for making decisions about the initiation and for monitoring HAART in resource-limited settings.

The effectiveness of biochemical indexes for evaluating the nutrition states of children / 소아과

PURPOSE: This study has been conducted to analyze whether the biochemical nutrition indexes might be useful and effective for evaluating the nutrition states of children. METHODS: We evaluated 269 children, aged 3-9 years old, who had visited Gangneung Asan Hospital for elective surgery from January 2006 to December 2007, and examined their anthropometric and preoperative laboratory data with retrospective analysis. The children were classified into underweight, normal weight, overweight, and obese groups according to body mass index (BMI). The biochemical nutrition indexes (total lymphocyte count (TLC), hemoglobin, hematocrit, serum albumin, cholesterol, et al) of each group were then analyzed statistically. RESULTS: None of the groups showed statistically significant differences in TLC. Serum albumin decreased significantly in the underweight group. Red blood cell (RBC) count, hemoglobin, hematocrit, and serum total cholesterol in the obese group were higher than in the normal weight group. None of the groups showed statistically significant increase in mean corpuscular volume or mean corpuscular hemoglobin, and it seems that the increase of hemoglobin and RBC count in the overweight and obese groups is due to the enhancement of erythropoiesis rather than iron metabolism. However, in females, almost all nutrition indexes except albumin were statistically significantly poor. CONCLUSION: Serum albumin, total cholesterol, RBC count, hemoglobin, and hematocrit were useful as nutrition indexes. However, except for albumin, these indexes were significantly poor for females. More control studies are needed to confirm the effectiveness of biochemical indexes for evaluating the nutritional state of children.

The Nutritional Assessment in Children: Understanding of Anthropometric Assessment and Biochemical Indexes in Children / 대한소아소화기영양학회지

Nutritional assessment is based on anthropometric, clinical, dietary and biochemical data. There is a lack of studies about the propriety of biochemical indexes for the nutritional assessment in children despite biochemical data in pediatric population are different from them in adult's in many respects. Serum albumin is useful index to evaluate the severity of malnutrition. Hemoglobin and hematocrit tend to decrease in malnutrition on account of defect of iron metabolism and to increase in metabolic syndrome on account of enhancement of erythropoiesis. But, unlike adult, total lymphocyte count is not so useful biochemical indexes in children. We should consider pediatric characteristic when interpret biochemical indexes for nutritional assessment in children, and nutritional status in children should be assessed comprehensively with anthropometric, clinical, dietary and biochemical data.

The correlation between total lymphocyte count and the number of candida colony from the oral cavity in HIV/AIDS patients.

HIV infection causes qualitative and quantitative reduction of the T helper (Th) subset of T lymphocytes, facilitating opportunistic infection. One of the common opportunistic infections among HIV/AIDS patients is Candida infection in the oropharynx and esophagus. Detection of increased Candida colonialization is not always easy, CD4 count is a parameter that could be used as reference. The fact is there’s only few laboratory can provide CD4 count. This study is a cross-sectional correlative study to determine the relation between total lymphocyte count as a much more applicable laboratory parameter and the intensity of Candida colonization in the oropharyngeal cavity of patients with HIV infection/AIDS. It was performed in the outpatient ward and inpatient ward of Dr. Cipto Mangunkusumo Hospital, from August 2004 to January 2005. The selected study subjects underwent interview, physical examination and had their blood samples and gargle samples taken. 60 study subjects were recruited, consisting of 52 males (86.7%) and 8 females (13.3%). The mean total lymphocyte count was 1194.53 cells/μL. Oropharyngeal candidiasis was found in 44 subjects (73.3%). There is a trend of higher Candida colonies number with lower total lymphocyte count despite no significant correlation between total lymphocyte count and the number of Candida colonies in the oral cavity of patients with HIV infection/AIDS. There is significant different between total lymphocyte count in positive and negative Candida colonies.

The Value of the Total Lymphocyte Count as a Risk Index of Hospital Infection in Critically Ill Patients / 대한마취과학회지

BACKGROUND: Lymphocytopenia is a common finding in critically ill patients while lymphocyte depletion in critically ill patients is presumed to have little clinical significance. However, a total lymphocyte count has been reported to provide prognostic information in surgical patients. The aim of this study was to evaluate the association of a total lymphocyte count (TLC) with a prognostic criterion in critically ill patients. METHODS: The patients were divided into three groups according to their TLC on admission to intensive care unit (ICU) (Group 1: TLC > 1.0 x 10(9)/L, Group 2: 0.7 x 10(9)/L < TLC < 1.0 x 10(9)/L, and Group 3: TLC <0.7 x 10(9)/L). Outcomes examined were patients' in-hospital mortality, length of hospital stay and incidence of infection. RESULTS: Patients with a TLC less than 0.7 x 10(9)/L (Group 3) had an infection twice (32% VS 15%) as often as those with a TLC more than 0.7 109/L (Group 1 2). But, in the hospital stay and mortality, there was no significant difference among the groups. CONCLUSIONS: TLC is very useful indicator in critically ill patients with a high risk of hospital infection on ICU admission.