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Total Lymphocyte Count as a Surrogate Marker to Predict CD4 Count in Human Immunodeficiency Virus-infected Children: A Retrospective Evaluation

Wang, Yuming PhD*,†; Li, Yuqian MM; Wang, Chongjian PhD*; Liang, Shuying MPH; Guo, Jinling PhD; Li, Zizhao MPH§; Zhang, Meixi MB*; Li, Wenjie PhD*

The Pediatric Infectious Disease Journal: January 2012 - Volume 31 - Issue 1 - p 61–63
doi: 10.1097/INF.0b013e318241d07e
HIV Reports

A retrospective study was conducted, and 576 human immunodeficiency virus–infected children with total lymphocyte count (TLC) and CD4 count were recruited from China. Spearman rank order correlation and receiver-operating characteristic were used. An overall positive correlation was noted between TLC and CD4 count (prehighly active antiretroviral therapy [pre-HAART], r = 0.789, 6 months of HAART, r = 0.642, 12 months of HAART, r = 0.691, P = 0.001). TLC ≤ 2600 cells/mm3 predicted a CD4 count of ≤350 cells/mm3 with 82.9% sensitivity, 79.6% specificity pre-HAART. Meanwhile, the optimum prediction for CD4 count of ≤350 cells/mm3 was a TLC of ≤2400 cells/mm3 at 6 months (73.6% sensitivity and 74.1% specificity) and 12 months (81.7% sensitivity and 76.5% specificity) of HAART. TLC can be used as a surrogate marker for predicting CD4 count of human immunodeficiency virus–infected children before and during HAART in resource-limited countries.

From the *Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China; †Henan Provincial Medical Academy, Zhengzhou, Henan, People's Republic of China; ‡Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, People's Republic of China; and §Center for AIDS/STD Control and Prevention, Department of Health of Henan Province, Zhengzhou, Henan, People's Republic of China.

Accepted for publication October 19, 2011.

Conflicts of interest and sources of funding: The research was supported by a grant from the Key Projects in the National Science & Technology Pillar Program during the Eleventh Five-Year Plan Period of China (Grant 2009ZX10001-017). The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Wang Chongjian, PhD, Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.