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Establishment of reference CD4+ T cell values for adult Indian population.

Thakar MR, Abraham PR, Arora S, Balakrishnan P, Bandyopadhyay B, Joshi AA, Devi KR, Vasanthapuram R, Vajpayee M, Desai A, Mohanakrishnan J, Narain K, Ray K, Patil SS, Singh R, Singla A, Paranjape RS - AIDS Res Ther (2011)

Bottom Line: The reference range for CD4% was 25-49% for male and 27-54% for female population.The reference values for CD3 counts were 776-2785 cells/μL for Indian male population and 826-2997 cells/μL for female population.The study used stringent procedures for controlling the technical variation in the CD4 counts across the sites and thus could establish the robust national reference ranges for CD4 counts and percentages.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Immunology, National AIDS Research Institute, G-73, MIDC, Bhosari, Pune, 411026, India. mthakar@nariindia.org.

ABSTRACT

Background: CD4+ T lymphocyte counts are the most important indicator of disease progression and success of antiretroviral treatment in HIV infection in resource limited settings. The nationwide reference range of CD4+ T lymphocytes was not available in India. This study was conducted to determine reference values of absolute CD4+ T cell counts and percentages for adult Indian population.

Methods: A multicentric study was conducted involving eight sites across the country. A total of 1206 (approximately 150 per/centre) healthy participants were enrolled in the study. The ratio of male (N = 645) to female (N = 561) of 1.14:1. The healthy status of the participants was assessed by a pre-decided questionnaire. At all centers the CD4+ T cell count, percentages and absolute CD3+ T cell count and percentages were estimated using a single platform strategy and lyse no wash technique. The data was analyzed using the Statistical Package for the Social Scientist (SPSS), version 15) and Prism software version 5.

Results: The absolute CD4+ T cell counts and percentages in female participants were significantly higher than the values obtained in male participants indicating the true difference in the CD4+ T cell subsets. The reference range for absolute CD4 count for Indian male population was 381-1565 cells/μL and for female population was 447-1846 cells/μL. The reference range for CD4% was 25-49% for male and 27-54% for female population. The reference values for CD3 counts were 776-2785 cells/μL for Indian male population and 826-2997 cells/μL for female population.

Conclusion: The study used stringent procedures for controlling the technical variation in the CD4 counts across the sites and thus could establish the robust national reference ranges for CD4 counts and percentages. These ranges will be helpful in staging the disease progression and monitoring antiretroviral therapy in HIV infection in India.

No MeSH data available.


Related in: MedlinePlus

The figure showed the frequency distribution of absolute CD4 counts in healthy Indian adults. The × axis shows the absolute CD4 counts and the Y axis shows the number of participants. The blue and red bar represents the number of male and female participants respectively.
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Figure 1: The figure showed the frequency distribution of absolute CD4 counts in healthy Indian adults. The × axis shows the absolute CD4 counts and the Y axis shows the number of participants. The blue and red bar represents the number of male and female participants respectively.

Mentions: The overall mean absolute CD4+ T cell count was 919 ± 312 cells/μL (median 877, range: 302-2371 cells/μL). Ninety eight percent of the study population showed absolute CD4 counts between 400-2000 cells/μL (Figure 1). The 17 male and 6 female participants showing CD4 counts less than 400 cells/μL are distributed throughout the four geographical regions and not confounded to any particular region. The absolute CD4 + T cell counts in female (mean: 995 ± 335, median: 953 cells/μL) were significantly higher than CD4+ T cell counts in male (mean: 852 ± 273, median: 822 cells/μL) participants. The region wise absolute CD4+ T cell counts from male and female study participants are given in table 2. The values were significantly higher in female than male participants in all the regions. Also there was significant difference amongst the mean CD4+ T cell counts of the female participants from all four geographical regions (p < 0.05). Whereas the CD4 counts of male participants from North and East regions and from South and West regions did not differ significantly. The absolute CD4 + T cell counts of the participants from Southern region were significantly higher than the CD4 counts of the participants from the other regions with the lowest CD4+ T cell counts in the participants from the Eastern region (Table 2). Since the normal distribution could not be achieved for absolute CD4 counts (both region and gender wise), the 2.5% and 97.5% percentile covering 95% of the population was considered to be the reference range for absolute CD4+ T cell counts. The reference range for absolute CD4+ T cell count for Indian male population was 381-1565 cells/μL and for female population was 447-1846 cells/μL.


Establishment of reference CD4+ T cell values for adult Indian population.

Thakar MR, Abraham PR, Arora S, Balakrishnan P, Bandyopadhyay B, Joshi AA, Devi KR, Vasanthapuram R, Vajpayee M, Desai A, Mohanakrishnan J, Narain K, Ray K, Patil SS, Singh R, Singla A, Paranjape RS - AIDS Res Ther (2011)

The figure showed the frequency distribution of absolute CD4 counts in healthy Indian adults. The × axis shows the absolute CD4 counts and the Y axis shows the number of participants. The blue and red bar represents the number of male and female participants respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198876&req=5

Figure 1: The figure showed the frequency distribution of absolute CD4 counts in healthy Indian adults. The × axis shows the absolute CD4 counts and the Y axis shows the number of participants. The blue and red bar represents the number of male and female participants respectively.
Mentions: The overall mean absolute CD4+ T cell count was 919 ± 312 cells/μL (median 877, range: 302-2371 cells/μL). Ninety eight percent of the study population showed absolute CD4 counts between 400-2000 cells/μL (Figure 1). The 17 male and 6 female participants showing CD4 counts less than 400 cells/μL are distributed throughout the four geographical regions and not confounded to any particular region. The absolute CD4 + T cell counts in female (mean: 995 ± 335, median: 953 cells/μL) were significantly higher than CD4+ T cell counts in male (mean: 852 ± 273, median: 822 cells/μL) participants. The region wise absolute CD4+ T cell counts from male and female study participants are given in table 2. The values were significantly higher in female than male participants in all the regions. Also there was significant difference amongst the mean CD4+ T cell counts of the female participants from all four geographical regions (p < 0.05). Whereas the CD4 counts of male participants from North and East regions and from South and West regions did not differ significantly. The absolute CD4 + T cell counts of the participants from Southern region were significantly higher than the CD4 counts of the participants from the other regions with the lowest CD4+ T cell counts in the participants from the Eastern region (Table 2). Since the normal distribution could not be achieved for absolute CD4 counts (both region and gender wise), the 2.5% and 97.5% percentile covering 95% of the population was considered to be the reference range for absolute CD4+ T cell counts. The reference range for absolute CD4+ T cell count for Indian male population was 381-1565 cells/μL and for female population was 447-1846 cells/μL.

Bottom Line: The reference range for CD4% was 25-49% for male and 27-54% for female population.The reference values for CD3 counts were 776-2785 cells/μL for Indian male population and 826-2997 cells/μL for female population.The study used stringent procedures for controlling the technical variation in the CD4 counts across the sites and thus could establish the robust national reference ranges for CD4 counts and percentages.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Immunology, National AIDS Research Institute, G-73, MIDC, Bhosari, Pune, 411026, India. mthakar@nariindia.org.

ABSTRACT

Background: CD4+ T lymphocyte counts are the most important indicator of disease progression and success of antiretroviral treatment in HIV infection in resource limited settings. The nationwide reference range of CD4+ T lymphocytes was not available in India. This study was conducted to determine reference values of absolute CD4+ T cell counts and percentages for adult Indian population.

Methods: A multicentric study was conducted involving eight sites across the country. A total of 1206 (approximately 150 per/centre) healthy participants were enrolled in the study. The ratio of male (N = 645) to female (N = 561) of 1.14:1. The healthy status of the participants was assessed by a pre-decided questionnaire. At all centers the CD4+ T cell count, percentages and absolute CD3+ T cell count and percentages were estimated using a single platform strategy and lyse no wash technique. The data was analyzed using the Statistical Package for the Social Scientist (SPSS), version 15) and Prism software version 5.

Results: The absolute CD4+ T cell counts and percentages in female participants were significantly higher than the values obtained in male participants indicating the true difference in the CD4+ T cell subsets. The reference range for absolute CD4 count for Indian male population was 381-1565 cells/μL and for female population was 447-1846 cells/μL. The reference range for CD4% was 25-49% for male and 27-54% for female population. The reference values for CD3 counts were 776-2785 cells/μL for Indian male population and 826-2997 cells/μL for female population.

Conclusion: The study used stringent procedures for controlling the technical variation in the CD4 counts across the sites and thus could establish the robust national reference ranges for CD4 counts and percentages. These ranges will be helpful in staging the disease progression and monitoring antiretroviral therapy in HIV infection in India.

No MeSH data available.


Related in: MedlinePlus