The Correlation between total lymphocyte count, hemoglobin levels, lymphocyte/leukocyte ratio (LLR), and lymphocyte/neutrophil ratio (LNR) to CD4 levels in patients with Human Immunodeficiency Virus infection at Sanglah Hospital

Wande, I Nyoman; Fuadi, M. Robiul; Hadi, Solichul

doi:10.15562/bmj.v8i2.1408

Cited by 9 publications

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“…TLC showed the strongest correlation with CD4 count (r=0.57), followed by lymphocyte/leukocyte ratio (r=0.51), and lymphocyte/neutrophil ratio (r=0.46), while the correlation with hemoglobin was the weakest (r=0.32). 30 This is consistent with our findings showing a significant association of both viral load and CD4 count<200 with TLC and hemoglobin, in addition to TLP, which is mathematically identical to the lymphocyte/leukocyte ratio used by Muhamad et al 30 …”

Section: Discussionsupporting

confidence: 92%

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

Al-Mughales

2023

HIV

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Objective This study aimed to test the validity of a composite score using complete blood count (CBC) for monitoring HIV patients receiving antiretroviral therapy (ART) in the absence of viral load and CD4 count. Methods This retrospective cohort study analyzed the laboratory data of 82 HIV patients who had pre- and post-treatment viral load, CD4 count, and CBC data. Pre- and post-treatment data were pooled to analyze the correlation of CBC parameters with Polymerase Chain Reaction (PCR) ranks and their performance in indicating a CD4 count<200 cells/mm3 using the Operating Characteristics Curve (ROC), with the determination of cutoffs. A score combining the significant parameters was tested to predict a CD4 count of <200. Results Total lymphocyte count (TLC), percentage (TLP), and hemoglobin concentration (Hb) were the most significant parameters, showing negative correlations with PCR (Spearman’s Rho = −0.357 to −0.242). The risk of acquired immunodeficiency syndrome (AIDS) was independently associated with TLC<1345 cells/mm3 (OR=2.92), TLP<29.07% (OR=3.53), and Hb<10.55 mg/dL (OR=3.60). A combined score of 2–3 indicated a CD4 count<200 with an odds ratio of 8.3–86.7. Conclusion The proposed 3-parameter score combining the use of TLC, TLP, and Hb, is an affordable and practical approach that may have clinical utility in monitoring HIV patients receiving ART in low-resource settings.

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Section: Discussionsupporting

confidence: 92%

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

Al-Mughales

2023

HIV

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“…The higher levels of hepcidin indicate the lower response of bone marrow erythropoisis. The low response of bone marrow erythoropoisis could be caused of the destruction of stem cells and bone marrow stroma, then impact on the function and number of blood cells [9]. Serum hepcidin has a negative correlation with hemoglobin levels which is consistent with what was reported by other studies.…”

Section: Discussionsupporting

confidence: 90%

Serum Hepcidin Level in Patients with Acute Lymphoblastic Leukemia (ALL) during The Treatment Phase: Their Effects on Erythropoisis Activity and Iron Reserves

2020

IJPR

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Hepcidin levels increased significantly with increased of iron stores in early phase of acute leukemia patients when erithropoisis pressed by blast cells in bone marrow, then decreased significantly with acute leukemia remission. The study aimed to determine role of hepcidin in activity of erythropoisis and serum iron reserves in acute lymphoblastic leukemia (ALL) patients during phase of therapy. This study used an observational analytic design. Serum hepcidin examination used ELISA methods. Erythropoisis activity was determined by complete blood and reticulocyte percentage. Iron reserves was determined by serum iron and ferritin levels by ECLIA. Result shows a total of 48 patient subjects were divided into groups of induction, consolidation and maintenance phase with an average age of 6.81 years (induction), 9.7 years (consolidation) and 7.8 years (maintenance). In the normality test with Shapiro-Wilk data showed abnormal distribution (p <0.05). Analysis by the Kruskal-Wallis test showed there were differences between the three treatment phases in the examination of hemoglobin, reticulocytes, serum iron, ferritin and hepcidin (p <0.05). In statistical analysis with Spearman's rank correlation shows there is a significant correlation between hemoglobin with ferritin (r = -0.416, p = 0.003), hemoglobin with hepcidin (r = -0.305, p = 0.035), reticulocytes with hepcidin (r = -0.496), p = 0.000) and serum iron with hepcidin (r = -0.302, p = 0.037). We concluded that the higher levels of hepcidin indicate lower levels of hemoglobin, reticulocytes and serum iron in patients with acute lymphoblastic leukemia during treatment phase.

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“…Since this anti-tuberculosis could cause the hepatitis, monitoring the side effects during treatment is essential and ethambutol is the only safe drug for people with liver disease. 23, 24 Besides side effect monitoring, the risk drug interaction between anti-tuberculosis drugs and other drugs must be evaluated.…”

Section: Case Reportmentioning

confidence: 99%

A patient with CD4+ T cells deficiency and HIV negative with pulmonary tuberculosis, tuberculous pleuritis and meningitis tuberculosis

Triwicaksana¹,

Rusli²,

Arfijanto³

et al. 2022

Bali Med J.

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Background: CD4+ T cells deficiency generally occurs in human immunodeficiency virus (HIV) patients, leading to some infections such as pulmonary and extrapulmonary tuberculosis. A rare case of decreased CD4+ T cells is idiopathic CD4+ T cell lymphocytopenia, a rare and unexplained immunodeficiency syndrome with no evidence of HIV infection. In this case report, we are reporting a patient with CD4+ T cells deficiency, pulmonary tuberculosis, pleuritis tuberculosis, and meningitis with HIV test negative. Case Presentation: A 58-year-old male was referred to the Emergency Department of Dr. Soetomo General Hospital with a gradual decrease of consciousness following six days of hospitalization at a private hospital. During hospitalization, one liter of fluid was evacuated from the right lung and analyzed, revealing tuberculosis infection. History of diabetes, hypertension, stroke, hepatitis, and cardiovascular disease was denied. The patient also never had chemotherapy or radiation treatment. Based on history taking, physical examination, and laboratory results, this patient has been diagnosed new case of pulmonary tuberculosis with deficiency CD4+ T cells and altered consciousness et causes meningitis tuberculosis with pleurisy tuberculosis. After 32 days of hospitalization with anti-mycobacterium therapy, the patient was improved and was discharged. Conclusion: This case highlights the challenges of having the definitive cause of CD4+ T cells deficiency either active tuberculosis infection or idiopathic CD4+ lymphocytopenia. Therefore, serial analyses of CD4+ T cells are advised on the patient during the treatment with anti-tuberculosis drug.

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The Correlation between total lymphocyte count, hemoglobin levels, lymphocyte/leukocyte ratio (LLR), and lymphocyte/neutrophil ratio (LNR) to CD4 levels in patients with Human Immunodeficiency Virus infection at Sanglah Hospital

Cited by 9 publications

References 0 publications

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

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

Serum Hepcidin Level in Patients with Acute Lymphoblastic Leukemia (ALL) during The Treatment Phase: Their Effects on Erythropoisis Activity and Iron Reserves

A patient with CD4+ T cells deficiency and HIV negative with pulmonary tuberculosis, tuberculous pleuritis and meningitis tuberculosis

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