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

IF 1.5 Q4 INFECTIOUS DISEASES HIV AIDS-Research and Palliative Care Pub Date : 2023-10-05 eCollection Date: 2023-01-01 DOI:10.2147/HIV.S431139
Jamil A Al-Mughales
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Abstract

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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利用血液学参数监测低资源环境中HIV/AIDS患者的三参数评分系统的开发和验证。
目的:本研究旨在检验在没有病毒载量和CD4计数的情况下,使用全血细胞计数(CBC)监测接受抗逆转录病毒治疗(ART)的HIV患者的复合评分的有效性。方法:本回顾性队列研究分析了82名HIV患者的实验室数据,这些患者在治疗前后有病毒载量、CD4计数和CBC数据。合并治疗前和治疗后的数据,分析CBC参数与聚合酶链式反应(PCR)等级的相关性及其在CD4计数中的表现。结果:总淋巴细胞计数(TLC)、百分比(TLP)和血红蛋白浓度(Hb)是最显著的参数,与PCR呈负相关(Spearman’s Rho=0.357至-0.242)。获得性免疫缺陷综合征(AIDS)的风险与TLC独立相关。结论:所提出的结合TLC、TLP和Hb的3参数评分是一种负担得起且实用的方法,在低资源环境中监测接受ART的HIV患者可能具有临床实用性。
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来源期刊
CiteScore
3.00
自引率
6.70%
发文量
61
审稿时长
16 weeks
期刊介绍: About Dove Medical Press Dove Medical Press Ltd is part of Taylor & Francis Group, the Academic Publishing Division of Informa PLC. We specialize in the publication of Open Access peer-reviewed journals across the broad spectrum of science, technology and especially medicine. Dove Medical Press was founded in 2003 with the objective of combining the highest editorial standards with the ''best of breed'' new publishing technologies. We have offices in Manchester and London in the United Kingdom, representatives in Princeton, New Jersey in the United States, and our editorial offices are in Auckland, New Zealand. Dr Scott Fraser is our Medical Director based in the UK. He has been in full time clinical practice for over 20 years as well as having an active research interest.
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