A rapid manual method for CD4+ T-cell quantitation for use in developing countries

Landay, Alan; Ho, John L.; Hom, David L.; Russell, Tom; Zwerner, Robert K.; Minuty, Jean Gardy; Kataaha, Peter; Mmiro, Francis; Jackson, J. Brooks

doi:10.1097/00002030-199312000-00004

Cited by 38 publications

(31 citation statements)

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“…Other studies compared the Cyto-Spheres assay with dual platform flow cytometry (DPFC) and detected intermediate to high correlations (r ¼ 0.74 to r ¼ 0.93) (8,(17)(18)(19)(20), whereas only one study found a substantially lower correlation (r ¼ 0.45) (6).…”

Section: Discussionmentioning

confidence: 99%

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Comparison of two alternative methods for CD4⁺ T‐cell determination (Coulter manual CD4 count and CyFlow) against standard dual platform flow cytometry in Uganda

Karcher¹,

Böhning

Downing

et al. 2006

Cytometry Part B Clinical

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Section: Discussionmentioning

confidence: 99%

“…In addition, the quality of the results depends on individual skills and experience of the laboratory technician. Results may also be less accurate due to the low number of total cells counted (250) per analysis (6,8,(17)(18)(19)(20).…”

Section: Advantages and Disadvantages Of The Manual Cyto-spheres Methmentioning

confidence: 99%

Comparison of two alternative methods for CD4⁺ T‐cell determination (Coulter manual CD4 count and CyFlow) against standard dual platform flow cytometry in Uganda

Karcher¹,

Böhning

Downing

et al. 2006

Cytometry Part B Clinical

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“…In response to this demand, we have compared the IA method with FC as the IA method is a purely manual method for T lymphocyte subsets determination, which has been adapted to field studies in tropical climate [8]. The IA method does not require advanced technology and is cheap in terms of supplies and technologist time: US$ 3.00 for a CD4 T lymphocyte determination compared to US$ 35.00 for a CD4 T lymphocyte determination by FC, excluding the very high costs of equipment and its maintenance [6]. The IA method has the advantage compared to FC and other alternative methodologies that the blood smears for T lymphocyte determination can be stored for long periods (months to years) and can be transported to other laboratories.…”

Section: Discussionmentioning

confidence: 99%

“…Simpler and less expensive methodologies for CD4 T lymphocyte determination which do not require advanced laboratory equipment are now available [5]. However, there are only a few studies examining the performance of these alternative methodologies in areas with limited laboratory facilities [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of T Cell Subsets by an Immunocytochemical Method Compared to Flow Cytometry in Four Countries

Lisse

Böttiger²,

Christensen

et al. 1997

Scand J Immunol

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The authors tested an alternative method for CD4 and CD8 T lymphocytes enumeration, the immunoalkaline phosphatase method (IA), in three African countries and in Denmark. The IA determinations from 136 HIV antibody positive and 105 HIV antibody negative individuals were compared to the corresponding results obtained by flow cytometry (FC) performed in the respective countries. The authors found good correspondence between the two methods for measurements of CD4 and CD8 T lymphocytes independent of serological status and geographical site. However, the CD4 and CD8 T lymphocyte values obtained by the two methods are not interchangeable as IA compared to FC consistently gives higher percentage of CD4 T lymphocytes, and lower percentages of CD8 T lymphocytes. Mean differences between the two methods did not differ between the three African countries indicating that the IA method provides systematic results. Replicate measurements suggested good correspondence between results obtained by IA. By using an IA level of < 300 CD4 T lymphocytes/ml, the sensitivity was 81% and specificity 96% for detecting an FC level of < 200 CD4 T lymphocytes/ml. Using an IA level of < 20% CD4 T lymphocytes, the sensitivity was 89% and specificity 95% for detecting an FC level of <14% CD4 T lymphocytes, The FC and IA methods had the same internal correspondence between low absolute CD4 T cell counts and low CD4 percentages; the sensitivity and specificity for detecting a low absolute CD4 T cell count with a low CD4 percentage was 92% and 68% for FC and 91% and 73% for IA, respectively. The IA method is 10-fold cheaper than FC, is independent of advanced laboratory facilities, and does not need immediate processing of samples as blood smears can be stored for long periods. The IA method is therefore suitable for use in areas with limited resources and laboratory facilities where there is a need for immunological surveillance in hospital or community studies.

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“…The cost of reagent, the skill and time required for performance of the assay, and the small number of tests that can be reliably performed daily by a trained technician make them unsuitable in many settings when other options are available (57,(66)(67)(68). More in-depth discussion of the different CD4þ T cell enumeration techniques for resource-limited settings is provided by other contributors to this issue of Cytometry B.…”

Section: Access In Sub-saharan Africamentioning

confidence: 99%

Clinical applications and availability of CD4+ T cell count testing in sub-Saharan Africa

Taiwo

Murphy

2008

Cytometry

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The absolute CD41 T cell count in adults and CD41 T cell percentage of lymphocytes (CD4%) in pediatrics compliment clinical history and physical examination to inform decisions about initiating antiretroviral therapy (ART). In addition, these immunologic markers predict host susceptibility to specific opportunistic infections, selected drug toxicities, and mortality. These benefits argue strongly for the availability of CD41 T cell testing capacity in all settings where HIV infection is treated. Several currently available flow cytometry-based devices, and novel CD41 T cell enumeration techniques such as the panleucogating CD4 are especially suitable for resource-constrained settings.At this time, unfortunately, the landscape of HIV care in sub-Saharan Africa is a mosaic characterized by large areas where CD41 T cell testing capacity is limited or unavailable, and small, but growing, pockets where the capacity exists. Routine HIV quantification is currently unaffordable and unsustainable in the great majority of the region; therefore, a reliance on CD41 T cell testing is inevitable for now. To this end, correcting the disparities in CD41 T cell testing capacity and defining the minimum laboratory requirements for the safe use of antiretroviral drugs through well-designed clinical studies are some of the most urgent priorities of the ongoing global scale-up of ART. q 2007 Clinical Cytometry Society

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A rapid manual method for CD4+ T-cell quantitation for use in developing countries

Cited by 38 publications

References 0 publications

Comparison of two alternative methods for CD4⁺ T‐cell determination (Coulter manual CD4 count and CyFlow) against standard dual platform flow cytometry in Uganda

Comparison of two alternative methods for CD4⁺ T‐cell determination (Coulter manual CD4 count and CyFlow) against standard dual platform flow cytometry in Uganda

Evaluation of T Cell Subsets by an Immunocytochemical Method Compared to Flow Cytometry in Four Countries

Clinical applications and availability of CD4+ T cell count testing in sub-Saharan Africa

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A rapid manual method for CD4+ T-cell quantitation for use in developing countries

Cited by 38 publications

References 0 publications

Comparison of two alternative methods for CD4+ T‐cell determination (Coulter manual CD4 count and CyFlow) against standard dual platform flow cytometry in Uganda

Comparison of two alternative methods for CD4+ T‐cell determination (Coulter manual CD4 count and CyFlow) against standard dual platform flow cytometry in Uganda

Evaluation of T Cell Subsets by an Immunocytochemical Method Compared to Flow Cytometry in Four Countries

Clinical applications and availability of CD4+ T cell count testing in sub-Saharan Africa

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Comparison of two alternative methods for CD4⁺ T‐cell determination (Coulter manual CD4 count and CyFlow) against standard dual platform flow cytometry in Uganda

Comparison of two alternative methods for CD4⁺ T‐cell determination (Coulter manual CD4 count and CyFlow) against standard dual platform flow cytometry in Uganda