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Near patient CD 4 count in a hospitalized HIV patient population
Author(s) -
Givens Monique,
Weaver Amanda,
Bickman Sarah,
Logan Cathy,
Noormahomed Emilia V.,
Patel Sam,
Schooley Robert T.,
Benson Constance A.,
Lochhead Michael J.
Publication year - 2017
Publication title -
cytometry part b: clinical cytometry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.646
H-Index - 61
eISSN - 1552-4957
pISSN - 1552-4949
DOI - 10.1002/cyto.b.21248
Subject(s) - flow cytometry , point of care , context (archaeology) , medicine , human immunodeficiency virus (hiv) , population , coefficient of variation , immunology , viral load , limits of agreement , andrology , biology , chemistry , pathology , nuclear medicine , chromatography , paleontology , environmental health
Background Point‐of‐care (POC) CD4 T‐cell counting is increasingly recognized as providing improved linkage‐to‐care during management of HIV infection, particularly in resource‐limited settings where disease burden is highest. This study evaluated prototype POC CD4 T‐cell counters from MBio Diagnostics in the context of low CD4 count, hospitalized patients in Mozambique. This study measured system performance when presented with challenging, low count samples from HIV/AIDS patients with acute illnesses resulting in hospitalization. Methods Forty whole blood samples were collected from donors on the medical service at Maputo Central Hospital and absolute CD4 counts were generated on the MBio CD4 system and a reference laboratory using flow cytometry. Results The mean and median CD4 counts by the flow cytometry reference were 173 and 80 cells/µL, respectively. Correlation between the MBio CD4 System and the reference was good. Bland‐Altman analysis showed a mean bias of +15 cells/µL (+9 to +21 cells/µL, 95% CI), and limits of agreement of −47 to 77 cells/µL. For samples with counts >100 cells/µL ( N = 14), the mean coefficient of variation was 7.3%. For samples with counts <50 cells/µL, mean absolute bias of replicate samples was 4.8 cells/µL. When two MBio readers were compared, Bland‐Altman bias was −4 cells/µL (−13 to +6 cells/µL, 95% CI), and limits of agreement of −63 and +55 cells/µL. Conclusions The MBio System holds promise as a POC system for quantitation of CD4 T cells in resource‐limited settings given system throughput (80–100 cartridges/day), design simplicity, and ease‐of‐use. © 2015 International Clinical Cytometry Society