Lab Med Online.  2017 Jan;7(1):7-12. 10.3343/lmo.2017.7.1.7.

The Usefulness of Hematological Parameters for Assessing Disease Progression in Patients with HIV Infection

Affiliations
  • 1Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea. jmkim@cnuh.co.kr
  • 2Department of Laboratory Medicine, Dae Cheong Hospital, Daejeon, Korea.
  • 3Division of Infectious Disease, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.

Abstract

BACKGROUND
In patients with HIV, CD4+ T cell count and viral load are the main laboratory tests performed to assess clinical management. However, they require extensive resources. In this study, we aimed to determine whether hematological parameters measured using a hematology analyzer are useful as surrogate markers of CD4+ T cell count and viral load in HIV-infected patients.
METHODS
Peripheral blood samples were obtained from 14 HIV-naïve, 105 HIV-treated, and 103 uninfected individuals. Hematological parameters were measured using the ADVIA 2120i hematology analyzer (Siemens Healthcare Diagnostics, USA).
RESULTS
In HIV-naïve and -treated patients, the percentage of large unstained cells (%LUCs) was 2.5±1.6% and 1.9±0.7%, respectively, compared to 1.6±0.5% in HIV-uninfected controls. The %LUCs was higher in HIV patients with low CD4⁺ T cell count below 200/μL (2.4±1.0%) or high viral load ≥200 copies/mL (2.4±0.8%) than in other infected groups. Significant differences in lymphocyte count were observed between the HIV-naïve (1.5±0.6×10⁹/L) and uninfected (2.0±0.6×10⁹/L) groups as well as between HIV patients with CD4⁺ T cells ≥500/μL (2.5±0.6×10⁹/L) and other infected groups. Neutrophil count varied between high viral load (3.0±1.4×10⁹/L) and low viral load (3.7±1.3×10⁹/L) groups. The CD4⁺ T cell count correlated with lymphocyte count (r=0.642, P<0.0001) and %LUCs (r=-0.287, P=0.002).
CONCLUSIONS
%LUCs, lymphocyte count, and neutrophil count are probable surrogate markers of CD4⁺ T cells and viral load.

Keyword

Large unstained cells; Hematological parameters; HIV; Antiretroviral therapy; CD4⁺ cell count; Viral load
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