Background. Acquired immunodeficiency syndrome (AIDS) is caused by the Human immunodeficiency virus (HIV) infection and characterized by a progressive decrease in the immune system function which eventually leads to the development of opportunistic infections and other complications. In order to monitor the disease progression the CD4 examination and additional Complete Blood Count (CBC) were commonly used.Objectives. To determine the correlation of total lymphocyte count, hemoglobin level, lymphocyte/leukocyte ratio (LLR) and lymphocyte/neutrophil ratio (LNR) to CD4 levels in patients with HIV infection.Methods. This a retrospective cross-sectional analytic study conducted from July to August 2017. The total lymphocyte count, hemoglobin level, lymphocyte/leukocyte ratio (LLR) and lymphocyte/neutrophil ratio (LNR) and CD4 level were measured in the study. The data normality and the correlation were analyzed using the Kolmogorov-Smirnov test and the Pearson Correlation test, respectively, performed in SPSS version 14. The p-value less than 0.05 was considered significant for the results.Results. A total of 60 samples conducted CD4 and complete blood counts (CBC) examinations during the period July-August 2017. The mean CD4 levels were 341.73 ± 243.48 cells/µL, the total leukocyte count was 6.98 ± 2.93 x 103/µL, the total lymphocyte count was 2.09 ± 0.87 x 103/µL, hemoglobin level 13.38 ± 2.09 g/dL, lymphocyte/leukocyte ratio (LLR) 0.31 ± 0.11, lymphocyte/neutrophil ratio (LNR) 0.67 ± 0.40. Statistical analysis showed that data is normally distributed. Pearson correlation analysis showed that there was a significant relationship between CD4 levels with total lymphocytes counts, hemoglobin levels, RLL, RLN with correlation coefficients of 0.571 (p = 0.000), 0.324 (p = 0.012), 0.509 (p = 0.000), 0.463 (p = 0.006), respectively. There was no significant correlation between CD4 levels and total leukocytes with a correlation coefficient of 0.171 (p = 0.19).Conclusion. There is a positive correlation between CD4 levels and total lymphocytes, hemoglobin levels, RLL and RLN in patients with HIV at Sanglah Hospital.
Sysmex XN-1000 hematology analyzer is an automated 5-part diff analyzer (eosinophils, basophils, neutrophils, lymphocytes, and monocytes). In the calculated area, the type of difference between the Sysmex hematology device and other hematology devices is Immature Granulocyte (IG), Nucleated Red Blood Cell (NRBC), and High Fluorescent Lymphocytes Count (HFLC). The cells calculated in the HFLC area are atypical lymphocytes. In patients with dengue hemorrhagic fever, it is often found atypical lymphocytes called blue plasma lymphocytes. The purpose of this study was to determine the description of HFLC in patients with dengue fever using the hematology analyzer Sysmex XN-1000. A descriptive retrospective study was conducted during April-May 2017. The subjects of the study were adult patients diagnosed with dengue hemorrhagic fever with WHO criteria. Of the 47 samples of Dengue Hemorrhagic Fever (DHF) patients, the average HFLC results were between 2.0-32.3%, which was 11.5%, while the average range of normal HFLC values was between 0.0-1.4% and was 0.3%. In cases of DHF, there is an increase in HFLC. This is likely to be attributed to atypical lymphocyte increase in dengue hemorrhagic fever. Further research with more varied samples still needs to be done.
There are several methods of hemoglobin screening. A technique that is practical, easy, and fast,as well as does not require high costs is needed for blood donor activities. Cupric sulfate method is still used in blood donor activities nowadays. There are several types of the specific gravity of cupric sulfate which will determine saturation speed. On the other hand, one of the requirements for a blood donor, according to the WHO, is that its hemoglobin level must be ≥ 12.5 g/dL. This research aims was to reveal how many blood droplets could be dripped into cupric sulfate solutions at certain specific gravities. This research was an observational analytic study using a cross-sectional design. One mL of venous blood sample was consecutively collected from thirty donors who came to the blood service of the Dr. R. Soedjono Selong Hospital in August 2017. Next, screening for hemoglobin levels was carried out on those blood samples using the cupric sulfate method with a specific gravity of 1.054. Autoanalyzer was also used as a reference method in this research. Results of cupric sulfate examination were categorized into sinking and non-sinking. The results of cupric sulfate examination with sinking category showed significant suitability with hemoglobin levels of >12.5 g/dL from autoanalyzer (p=0.002) with 100% sensitivity and 70.83% specificity. The results of cupric sulfate examination with non-sinking category (with daily replacement) showed a significant match with hemoglobin levels of >12.5 g/dL from autoanalyzer (p=0.003) with 68% sensitivity and 100% specificity. The use of ten samples in this research could reach 100% sensitivity and 100% specificity. Meanwhile, according to the WHO, 30 mL of cupric sulfate solution with a specific gravity of 1.053 can accommodate 25 donor blood droplets.Thus, it can be concluded that unlike the reference from the WHO of 25 droplets, based on hemoglobin screening test cupric sulfate solution with a specific gravity of 1,054 can be saturated with ten droplets.
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