Total Lymphocyte Count (TLC) Is a Useful Tool for the Timing of Opportunistic Infection Prophylaxis in India and Other Resource-Constrained Countries

2002 ◽  
Vol 31 (4) ◽  
pp. 378-383 ◽  
Author(s):  
N. Kumarasamy ◽  
Anish P. Mahajan ◽  
Timothy P. Flanigan ◽  
R. Hemalatha ◽  
Kenneth H. Mayer ◽  
...  
2010 ◽  
Vol 4 (10) ◽  
pp. 645-649 ◽  
Author(s):  
Sreenivasan Srirangaraj ◽  
Dasegowda Venkatesha

Introduction: In resource-limited settings, due to the high cost of CD4 cell count testing, physicians must decide about opportunistic infection (OI) prophylaxis without a laboratory evaluation of HIV stage and level of immune suppression. This study aimed to evaluate the correlation of total lymphocyte count (TLC), an inexpensive laboratory parameter, to CD4 count, and to determine a range of TLC cut-offs for the initiation of OI prophylaxis that is appropriate for resource-limited settings. Methodology: Spearman correlation between CD4 count and TLC was assessed in patients attending the Anti-Retroviral Therapy (ART) centre at Mysore, India. Positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity of various TLC cut-offs were computed for CD4 counts < 200 cells/mm3. Correlation and statistical indices were computed for all patients and for HIV patients with active tuberculosis. Results: Good correlation was noted between the 106 paired TLC and CD4 counts (r = 0.3497).TLC < 1200cells/mm3 had 88.14% sensitivity and 34.78% specificity for CD4 count < 200 cells/mm3. In those patients with active tuberculosis, TLC< 2000cells/mm3 had 95.24% sensitivity and 100% specificity for CD4 count < 200cells/ mm3. Conclusions: TLC could serve as a low-cost tool for determining when to initiate prophylaxis in resource-constrained settings.


1996 ◽  
Vol 7 (6) ◽  
pp. 422-428 ◽  
Author(s):  
E J Beck ◽  
E J Kupek ◽  
M M Gompels ◽  
A J Pinching

The aim of this study was to assess the correlation and average cost of total lymphocyte count compared with CD4 count as a broad estimate of immunosuppression in HIV-1 infected individuals. Spearman's partial rank correlation were calculated between total lymphocyte count, absolute CD4 count and CD4 per cent stratified by stage of HIV-1 infection for routinely collected samples. Data were collected prospectively from a T cell-subset register combined with clinical data obtained retrospectively from case notes of HIV-infected patients managed at St Mary's Hospital, London 1982-1991. Costing data were obtained through a survey of the departments of haematology and immunology 1989 90 prices . The correlation between 1534 paired absolute lymphocyte count and CD4 lymphocyte count was found to be high R 0.76 . When analysed by stage of HIV infection, the correlation increased from R 0.64 for asymptomatic patients, to R 0.72 for patients with symptomatic non-AIDS HIV infection and R 0.73 for AIDS patients. Correlations between absolute lymphocyte count and CD4 per cent were considerably weaker: R 0.41 all paired counts; R 0.32 for asymptomatic patients; R 0.25 for symptomatic non-AIDS patients; R 0.32 for AIDS patients. Average cost was 8 per full blood count compared with 38 per T-cell subset analysis. The high correlation between total and CD4 lymphocyte counts, especially for patients with symptomatic HIV disease, demonstrates the suitability of the use of total lymphocyte count in the absence of CD4 counts. Given the considerably lower prices of total lymphocyte counts compared with T-cell subset analysis, this is particularly relevant for developing countries.


2010 ◽  
Vol 29 (1) ◽  
pp. 89-93 ◽  
Author(s):  
Brendan J. O'Daly ◽  
James C. Walsh ◽  
John F. Quinlan ◽  
Gavin A. Falk ◽  
Robert Stapleton ◽  
...  

2016 ◽  
Vol 94 (4) ◽  
pp. 389-392 ◽  
Author(s):  
K. Schatz ◽  
W. Guffey ◽  
M. Maccia ◽  
M. Templin ◽  
K. Rector

2017 ◽  
Vol 5 (1) ◽  
pp. 56
Author(s):  
Rizka Bekti Nurcahyani ◽  
Imelda T Pardede ◽  
Huriatul Masdar

Adequate nutrition is one of important factors in immunodeficiency repairment. Soybean and tempeh contains proteins,zinc, ferrum, vitamins and isoflavon. Fermentation in tempeh makes it having better nutrients digestion and absorptionthan soybean. The objective of this study was to compare the effects of soy and tempeh emulsions on total lymphocytecount in rats treated with prednisone. The test was done on 24 male white rats divided into four groups. Group A wasgiven distilled water and group B, C and D had prednisone 2.5 mg/day for 6 days. After that, group A and B werecontinued having distilled water while groups C or D was fed with soy or tempeh emulsion 0.71 mL/day for 10 days,respectively. The results shown that soy and tempeh emulsion could increase total lymphocyte count significantly (p <0,05) but there was no significant difference of total lymphocyte count between soy and tempeh emulsion groups (p >0,05).


2015 ◽  
Author(s):  
Robert Robinson

Introduction: Hospital readmission within 30 days of discharge is a target for health care cost savings through the medicare Value Based Purchasing initiative. Because of this focus, hospitals and health systems are investing considerable resources into the identification of patients at risk of hospital readmission and designing interventions to reduce the rate of hospital readmission. Malnutrition is a known risk factor for hospital readmission. Materials and Methods: All medical patients 65 years of age or older discharged from Memorial Medical Center from January 1, 2012 to March 31, 2012 who had a determination of serum albumin level and total lymphocyte count on hospital admission were studied retrospectively. Admission serum albumin levels and total lymphocyte counts were used to classify the nutritional status of all patients in the study. Patients with a serum albumin less than 3.5 grams/dL and/or a TLC less than 1,500 cells per mm3 were classified as having protein energy malnutrition. The primary outcome investigated in this study was hospital readmission for any reason within 30 days of discharge. Results: The study population included 1,683 hospital discharges with an average age of 79 years. The majority of the patients were female (55.9%) and had a DRG weight of 1.22 (0.68). 219 patients (13%) were readmitted within 30 days of hospital discharge. Protein energy malnutrition was common in this population. Low albumin was found in 973 (58%) patients and a low TLC was found in 1,152 (68%) patients. Low albumin and low TLC was found in 709 (42%) of patients. Kaplan-Meier analysis shows any laboratory evidence of PEM is a significant (p < 0.001) predictor of hospital readmission. Low serum albumin (p < 0.001) and TLC (p = 0.018) show similar trends. Cox proportional-hazards regression analysis showed low serum albumin (Hazard Ratio 3.27, 95% CI: 2.30-4.63) and higher DRG weight (Hazard Ratio 1.19, 95% CI: 1.03-1.38) to be significant independent predictors of hospital readmission within 30 days. Discussion: This study investigated the relationship of PEM to the rate of hospital readmission within 30 days of discharge in patients 65 years of age or older. These results indicate that laboratory markers of PEM can identify patients at risk of hospital readmission within 30 days of discharge. This risk determination is simple and identifies a potentially modifiable risk factor for readmission: protein energy malnutrition.


2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Nyawira Githinji ◽  
Elizabeth Maleche-Obimbo ◽  
Moses Nderitu ◽  
Dalton C Wamalwa ◽  
Dorothy Mbori-Ngacha

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