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Haematological Parameters in PLHIV with Utility of Absolute Lymphocyte Count (ALC) As Surrogate Marker for CD4 Count: A Study from India

Singh Swati, Junior Resident, Department of Pathology, R.C.S.M. Govt Medical College and CPR Hospital, Kolhapur, Maharashtra 416002, India. , Singh Swati1 , Namey R.D.2

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Indian Journal of Pathology: Research and Practice 7(5):p 691-697, May 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7518.21

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Abstract

  Context: Since it’s first report in 1982, HIV has emerged as a major pandemic. Haematological abnormalities are among the most common clinicopathological manifestations of HIV infection including impaired haematopoiesis, immune mediated cytopenias and coagulopathies.

Aims: To study haematological parameters in PLHIV and to correlate them with CD4 count. To correlate Absolute Lymphocyte Count (ALC) with CD4 count to evaluate the utility of ALC as a surrogate marker for CD4 count.

Settings and Design: Prospective observational study 

Methods and Material: After obtaining informed consent, 225 PLHIV were clinically evaluated and subjected to CBC, PBS, ALC, ESR and CD4 count. Statistical analysis used: Data was expressed as percentage and mean±standard deviation. Statistical tests used were chi-square test, Fisher’s exact test and Mann-Whitney U test and Kolmogorov-smirnov analysis. Also, Pearson’s rank order correlation and ROC curve was used.

Results: The important haematological findings noted were anaemia (n=123,54.6%), leucopenia(n=34,15.2%), lymphocytopenia (n=128,56.9%), thrombocytopenia (n=10,4.4%) and raised ESR (n=162,72%). CD4 count was reduced in 156 cases (69.3%). Haemoglobin, MCV, MCH and ALC (p<0.0001) showed significant positive correlation with CD4 count. ALC ï‚£ 1400cells/µl indicated CD4<200cells/µl.

Conclusions: The most frequent haematological finding is lymphocytopenia followed by anaemia. Haemoglobin, MCV, MCH and ALC showed rise with increase in CD4 count. ALC ï‚£ 1400cells/µl can act as surrogate marker for CD4<200cells/µl in resource poor settings.

Keywords: Absolute Lymphocyte Count; CD4 Count; ESR; Haematological Parameters; PLHIV.

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DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7518.21

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