Prediksi Jumlah Sel Limfosit T Cd4+ Menggunakan Nilai TLC (Total Lymphocyte Count) Pada Penderita Hiv/Aids

Abstract

AIDS is a severe disease caused by Human Immunodeficiency Virus (HIV) that affects patient’s immune system, especially CD4+ Tcells (CD4). Hence, CD4 count is used as parameter to starting ARV treatment or monitoring the progress of the disease. However, themeasurement of CD4 is expensive and available in big hospitals. In small or remote hospitals there are no means to measure the CD4.Some studies suggest that in an area where CD4 count is unavailable, the total lymphocyte count (TLC) of HIV/AIDS patients can roughlybe used to predict CD4 values. This study is aimed to see whether the TLC values can be used to roughly predict the CD4 count of HIV/AIDS patients and to formulate the correlation form between them. A cross sectional study design was applied to 79 blood samples ofHIV/AIDS patients from Clinical Pathology Laboratory of Wahidin Sudirohusodo Hospital from January to September 2007. The bloodsamples were tested for TLC as well as CD4 values. The correlation of TLC and CD4 values was tested with Pearson Correlation Test andthe correlation formula was derived from curve estimation of Regression Analysis. Sensitivity, specificity, PPV and NPV of various cutpoint of TLC (1000, 1200, 1500, 2000) to predict CD4 < 200/ul were determined using cross tabulation Fisher Exact Test. A positivecorrelation was found between TLC and CD4 count (R = 0.528, p < 0.001) with the regression formula is CD4 = 0.09TLC – 1.42.The WHO standard cut point TLC1200/ul give best result for sensitivity, specificity, PPV and NPV: 80.6%, 91.7%, 98.2% and 45.8%,respectively. The cut point of TLC1200 can be used to roughly predict CD4 < 200/ul of HIV/AIDS patients, so, can be use as a mark forstarting ARV therapy in the place were measurement of CD4 is unavailable

Total Lymfosit Count (TLC) with CD4 in HIV/AIDS Patients at Kupang

“…CD4 cells are the largest part of T lymphocytes, which is 34-67%. 3,19,20 In HIV infection, selective reduction in CD4 cells is found due to the direct effects of the virus or the body's immune response. This selective reduction is due to the tropism of the virus to infect CD4 cells.…”

“…1,2 The highest number of cases of infection were DKI Jakarta with 51,981 people, followed by East Java with 39,633 people, Papua 29,083 people, West Java 28,964 people and Central Java with 22,292 people. 2,3 Based on data from the Directorate General of Disease Prevention and Control, the Ministry of Health of the Republic of Indonesia in 2017 in East Nusa Tenggara Province the Human Immunodeficiency Virus (HIV) is a retrovirus originating from the retroviridae family of the genus lentivirus that infects and damages cells that have a molecule Cluster of Differentiation 4 (CD4), especially T lymphocytes that have receptors with high affinity for HIV. Total lymphocyte count / TLC has been proposed as an alternative guide to CD4 in limited health facilities.…”

Vitamin D, Body Mass Index, and Total Lymphocyte Count in Drug-Sensitive and Drug-Resistant Tuberculosis Patients in Banjarmasin

“…14 In a study by Rostina (2008), TLC was calculated from leukocyte x lymphocytes in percentage based on the Ministry of Health of the Republic of Indonesia. 15…”

Development and Validation of a Three-Parameter Scoring System for Monitoring HIV/AIDS Patients in Low-Resource Settings Using Hematological Parameters

“…11 Several other studies have discussed the use of TLC as a surrogate for HIV progression over the past years. [13][14][15] Other studies have suggested that TLC combined with blood hemoglobin level provides more sensitive predictions for the progression of HIV. [16][17][18] Other data highlight further hematological dysfunctions in HIV patients, such as normocytic normochromic anemia, thrombocytopenia, and monocytosis, which are associated with immunological and clinical severity and stage of the disease and tend to improve after ART initiation.…”