CD4+ T-lymphocyte count/CD8+ T-lymphocyte count ratio: surrogate for HIV infection in infants?

Abstract:

INTRODUCTION:Early diagnosis and treatment is necessary to prevent HIV-infected infants progressing to AIDS. Antibody testing is not confirmatory before the age of 18 months and PCR not widely available in resource-poor settings. We studied the accuracy of CD4(+) T-lymphocyte count, CD4% and CD4/CD8 ratio as surrogate markers of infant HIV infection. METHODS:Two hundred and fifty-eight HIV-exposed Indian infants at a median age of 5 months (range 1-18) had DNA PCR and CD4, CD8 counts performed. RESULTS:Fifty five infants tested positive by HIV-1 DNA PCR whereas 203 were negative. Median CD4 count, CD4% and CD4/CD8 ratio were significantly lower in DNA PCR+ infants. Overall sensitivity and specificity of CD4/CD8 ratio <1.0 in predicting HIV was 91 and 92% with a negative predicted value (NPV) and positive predicted value (PPV) of 97 and 76%, respectively. CONCLUSION:CD4/CD8 ratio <1.0 is a more sensitive surrogate marker of HIV infection in Indian infants than a CD4 count <1500 cells/µl or CD4% <25%.

journal_name

J Trop Pediatr

authors

Navaneethapandian PG,Karunaianantham R,Subramanyan S,Chinnayan P,Chandrasekaran P,Swaminathan S

doi

10.1093/tropej/fmr102

subject

Has Abstract

pub_date

2012-10-01 00:00:00

pages

394-7

issue

5

eissn

0142-6338

issn

1465-3664

pii

fmr102

journal_volume

58

pub_type

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