CD4 count is the standard
method for determining eligibility for
highly active antiretroviral therapy (
HAART) and
monitoring HIV/
AIDS disease progression,but it is not widely available in
resource-limited settings.This study examined the correlation between
total lymphocyte count (TLC) and
CD4 count of
HIV-infected
patients before and after
HAART,and assessed the thresholds of TLC for making decisions about the initiation and for
monitoring HAART.A
retrospective study was performed,and 665
HIV-infected
patients with TLC and
CD4 count from four counties (Shangcai,Queshan,Shenqiu and Weishi) were included in the study.Pearson correlation and
receiver operating characteristic (ROC) were used.TLC and
CD4 count after
HAART was significantly increased as compared with pre-
HAART (P<0.01).An overall positive correlation was noted between TLC and
CD4 count (pre-
HAART,r=0.73,P=0.0001; follow-up
HAART,r=0.56,P=0.0001).The
ROC curve between TLC and
CD4 count showed that TLC ≤ 1200
cells/mm3 could predict CD4 < 200
cells/mm3 with a
sensitivity of 71.12%,
specificity of 66.35%at pre-
HAART.After 12-month
HAART,the optimum prediction for
CD4 count < 200
cells/mm3 was a TLC ≤ 1300
cells/mm3,with a
sensitivity of 63.27%,and a
specificity of 74.84%.Further finding indicated that TLC change was positively correlated to CD4 change (r=0.77,P=0.0001) at the
time point of 12- month
treatment,and the best prediction point of TLC change for CD4 increasing was 135
cells/mm3.TLC and its change can be used as a
surrogate marker for
CD4 count and its change of
HIV-infected individuals for making decisions about the initiation and for
monitoring HAART in
resource-limited settings.