Document Type : Original Article
Authors
1
Department of Pathology, Resident Doctor, RNT Medical College Udaipur
2
Department of Pathology, Associate Professor, RNT Medical College, Udaipur
3
Department of Pathology, Resident Doctor, RNT Medical College, Udaipur
4
Department of Internal Medicine, Resident Doctor, Aiims, New Delhi
5
Department of Pathology, Senior Resident Doctor,Netaji Subhash chandra bose medical college,Jabalpur
10.30485/ijsrdms.2026.582246.1704
Abstract
Background and aim: CD4+ T-lymphocyte count is the gold standard for assessing immune status in HIV infection; however, flow cytometry is expensive and often unavailable in resource-limited settings. This study evaluated the correlation between CD4 count and absolute lymphocyte count (ALC), Haemoglobin (Hb), and platelet count in HIV-positive patients and assessed their utility as surrogate markers of immunosuppression.
Material and methods: A descriptive cross-sectional study was conducted among 245 confirmed HIV-positive patients attending the ART centre at M.B. Government Hospital, Udaipur, Rajasthan. Complete blood counts were analyzed using a five-part automated haematology analyzer, and CD4 counts were measured by flow cytometry. Pearson's correlation and diagnostic validity statistics (sensitivity, specificity, PPV, NPV) were calculated using CD4 ≤200 cells/mm³ as the reference threshold.
Results: The mean age was 40.06 ± 12.9 years, with male predominance (60.8%). CD4 ≤200 cells/mm³ was observed in 42.1% of patients. Anaemia (Hb ≤12 g/dL) was present in 43.7%, ALC ≤1200 cells/mm³ in 26.1%, and thrombocytopenia in 22.0%. ALC showed a significant moderate positive correlation with CD4 count (r = 0.482, p < 0.05) and high specificity (86.6%). Hb showed a weaker but significant correlation (r = 0.272, p = 0.002). Platelet count and total leucocyte count did not correlate significantly with CD4 levels.
Conclusions: ALC demonstrates a moderate, statistically significant correlation with CD4 count and may serve as a cost-effective triage marker in resource-limited settings where CD4 testing is unavailable; however, its relatively low sensitivity (43.7%) limits standalone diagnostic utility. Haemoglobin may serve as an adjunct indicator of disease progression.
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