Reference values are essential for the interpretation of hematologic data in clinical practice and research studies. Symptom-free human immunodeficiency virus antibody-negative Ugandan adults (183 subjects, aged 15 to 74 years, 37.7% women and 62.3% men) were studied to establish hematological reference ranges. The central 95% areas under the distribution curves were 1,453 to 4,448 cells per l for the absolute lymphocyte count, 559 to 2,333 cells per l for the absolute CD4 count, 253 to 1,396 cells per l for the absolute CD8 count, and 0.68 to 4.4 for the CD4/CD8 ratio. Women had significantly higher mean absolute lymphocyte counts (2,826 versus 2,568/l), absolute CD4 counts (1,425 versus 1,154/l), and absolute CD4/CD8 ratios (2.58 versus 1.88) than did men. These reference ranges differ from those reported for populations outside Africa.
Mean serum beta-2 microglobulin levels among healthy human immunodeficiency virus-seronegative and asymptomatic and symptomatic human immunodeficiency virus-seropositive Ugandans were found to be 2.35, 3.75, and 5.06 mg/liter, respectively (P < 0.001). The upper limit of the normal range (3.5 mg/liter) is higher in this African population than that reported elsewhere.
The accuracy and acceptability of saliva human immunodeficiency virus type 1 (HIV-1) antibody testing were compared with serum testing in a study of paired specimens from HIV-1-seropositive and HIV-1-seronegative Ugandan adults attending a clinic for sexually transmitted diseases. Saliva collection was performed with the Omni-sal device (Saliva Diagnostic Systems, Vancouver, Wash.), and antibody testing was performed by a rapid filter paper assay (Test-Pack; Abbott Laboratories, Abbott Park, Ill.). Relative to serum testing, the sensitivity of saliva testing was 95% (195 of 205) and the specificity was 99% (295 of 297). The sensitivity of saliva testing was higher for patients with elevated levels of beta-2 microglobulin in sera and greater numbers of HIV-1-related symptoms. Pre-and poststudy interviews indicated that saliva testing did not foster inordinate fears of saliva exposure. The development of saliva tests that are inexpensive and do not require electricity is needed.
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