Blood haemoglobin measurement as a predictive indicator for the progression of HIV/AIDS in resource-limited setting

Obirikorang, Christian; Yeboah, Francis Agyemang

doi:10.1186/1423-0127-16-102

Cited by 75 publications

(85 citation statements)

References 38 publications

(36 reference statements)

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“…Current study results showed a small significant correlation of Hb to CD4 count which correlated well with several studies in Africa (Obirikorang and Yeboah, 2009;Owiredu et al, 2011;Wisaksana et al, 2011). In this study, a cut-off point of 10 g/dl had very low sensitivity.…”

Section: Markersupporting

confidence: 74%

“…There was no correlation observed between RBC indices (MCH, MCHC and MCV) in this study. In contrast, in two different studies of RBC parameters and HIV, there was a significant decrease in RBC, RBC indices MCV and MCH (Obirikorang and Yeboah, 2009;Tagoe and Asantewaa, 2011). The results of this study exhibited no correlation of platelets to CD4 counts.…”

Section: Markermentioning

confidence: 96%

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Development of an algorithm of haematologic parameters as surrogate markers for CD4 cell count in resource-limited settings

Kwamboka¹,

Juliette²,

Amos³

et al. 2016

J. Med. Lab. Diagn.

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Total Lymphocyte Count (TLC) has been previously evaluated as a surrogate for CD4 counts in the management of HIV especially in resource-limited settings with varying results. This study developed a clinical algorithm of TLC and other significant haematologic parameters to raise the predictive value of TLC in classifying subjects with CD4 count <350 cells/mm 3 . Total samples of 215 HIV-seropositive ARVnaïve patients were studied. The Beckman Counter was used for Complete Blood count (CBC), Beckton Dickinson FACS count for CD4 count, and Westergren method for Erythrocyte Sedimentation Rate (ESR). The variables retained as the most significant predictors (at p<0.05) were TLC<2000 cells/mm 3 (sensitivity 71.5%, specificity 73.4%, PPV 69.1%, NPV 78.3%), Hb < 12 g/dl (sensitivity 59.8%, specificity 56.2%, PPV 63.3%, NPV 71%) and ESR>30 mm/h(sensitivity 57%, specificity 71%, PPV 66%, NPV 68%). A three-step algorithm of TLC <2000 cells/mm 3 , Hb<12 g/dl, and ESR>30 mm/h for predicting CD4 count<350 cells/mm 3 yielded sensitivity 66%, specificity 82%, PPV 72%, NPV 77% (area under curve AUC 0.79). This algorithm had a higher predictive accuracy making it a better tool than the use of TLC alone in monitoring disease progression in resource-limited settings.

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Section: Markersupporting

confidence: 74%

Section: Markermentioning

confidence: 96%

Development of an algorithm of haematologic parameters as surrogate markers for CD4 cell count in resource-limited settings

Kwamboka¹,

Juliette²,

Amos³

et al. 2016

J. Med. Lab. Diagn.

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“…progression and death in individuals with HIV (4,11,(20)(21)(22)(23)(24). It is not clear why anemia is associated with risk of HIV progression, although it is unlikely that it has a direct effect.…”

Section: Discussionmentioning

confidence: 99%

“…In order to identify and monitor patients at risk of disease progression in resource-poor settings, the prognostic significance of various surrogate markers has been investigated (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Researchers have proposed many alternative markers, including hemoglobin (Hb) (6)(7)(8)(9)(10)(11), total lymphocyte count (TLC) (7,14,15), delayed-type hypersensitivity responses (5), serum albumin levels (13), neopterin (16), and body mass index (17). Due to the general availability of complete blood cell count (CBC) tests, particularly in resource-poor setting areas, this study investigated the prognostic value of CBC markers in HIV progression.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Non-Viral Surrogate Markers as Predictive Indicators for Monitoring Progression of Human Immunodeficiency Virus Infection: An Eight-Year Analysis in a Regional Center

et al. 2016

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SUMMARY: Suitable methods for clinical monitoring of HIV-infected patients are crucial in resourcepoor settings. Demographic data, clinical staging, and laboratory findings for 112 asymptomatic subjects positive for HIV were assessed at the first admission and the last visit from 2002 to 2010. Cox regression analysis showed hemoglobin (Hb) (HR ＝ 0.643, P ＝ 0.021) to be a predictive indicator for disease progression, while CD4, CD8, and platelet counts showed low HRs, despite having significant probability values. Hb and total lymphocyte count (TLC) rapidly declined from stage II to III (10.9 and 29.6z, respectively). Reduced CD4 and platelet counts and Hb during stage I were associated with disease progression, and TLC was correlated with CD4 counts at the last follow-up (P ＜ 0.001). However, WHO TLC cutoff of 1,200 cell/mm 3 had 26.1z sensitivity and 98.6z specificity. ROC curve analysis suggested that a TLC cutoff of 1,800 cell/mm 3 was more reliable in this region. Statistical analysis and data mining findings showed that Hb and TLC, and their rapid decline from stage II to III, in addition to reduced platelet count, could be valuable markers for a surrogate algorithm for monitoring of HIVinfected subjects and starting anti-viral therapy in the absence of sophisticated detection assays.

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“…For example, anemia frequently complicates HIV infection, is associated with faster progression, and is an independent risk factor for mortality. [14][15][16][17] In addition, anemic HIV-infected patients are more likely to require hospitalization or transfusion from a hemolytic crisis.…”

mentioning

confidence: 99%

G6PD Deficiency in an HIV Clinic Setting in the Dominican Republic

Francis

Nadal

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Because human immunodeficiency virus (HIV)-infected patients receive prophylaxis with oxidative drugs, those with glucose-6-phosphate dehydrogenase (G6PD) deficiency may experience hemolysis. However, G6PD deficiency has not been studied in the Dominican Republic, where many individuals have African ancestry. Our objective was to determine the prevalence of G6PD deficiency in Dominican HIV-infected patients and to attempt to develop a cost-effective algorithm for identifying such individuals. To this end, histories, chart reviews, and G6PD testing were performed for 238 consecutive HIV-infected adult clinic patients. The overall prevalence of G6PD deficiency (8.8%) was similar in males (9.3%) and females (8.5%), and higher in Haitians (18%) than Dominicans (6.4%; P = 0.01). By logistic regression, three clinical variables predicted G6PD status: maternal country of birth (P = 0.01) and a history of hemolysis (P = 0.01) or severe anemia (P = 0.03). Using these criteria, an algorithm was developed, in which a patient subset was identified that would benefit most from G6PD screening, yielding a sensitivity of 94.7% and a specificity of 97.2%, increasing the pretest probability (8.8-15.1%), and halving the number of patients needing testing. This algorithm may provide a cost-effective strategy for improving care in resource-limited settings.

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Blood haemoglobin measurement as a predictive indicator for the progression of HIV/AIDS in resource-limited setting

Cited by 75 publications

References 38 publications

Development of an algorithm of haematologic parameters as surrogate markers for CD4 cell count in resource-limited settings

Development of an algorithm of haematologic parameters as surrogate markers for CD4 cell count in resource-limited settings

Evaluation of Non-Viral Surrogate Markers as Predictive Indicators for Monitoring Progression of Human Immunodeficiency Virus Infection: An Eight-Year Analysis in a Regional Center

G6PD Deficiency in an HIV Clinic Setting in the Dominican Republic

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