CD4 enumeration technologies: a systematic review of test performance for determining eligibility for antiretroviral therapy

PloS One
Rosanna W PeelingNathan Ford

Abstract

Measurement of CD4+ T-lymphocytes (CD4) is a crucial parameter in the management of HIV patients, particularly in determining eligibility to initiate antiretroviral treatment (ART). A number of technologies exist for CD4 enumeration, with considerable variation in cost, complexity, and operational requirements. We conducted a systematic review of the performance of technologies for CD4 enumeration. Studies were identified by searching electronic databases MEDLINE and EMBASE using a pre-defined search strategy. Data on test accuracy and precision included bias and limits of agreement with a reference standard, and misclassification probabilities around CD4 thresholds of 200 and 350 cells/μl over a clinically relevant range. The secondary outcome measure was test imprecision, expressed as % coefficient of variation. Thirty-two studies evaluating 15 CD4 technologies were included, of which less than half presented data on bias and misclassification compared to the same reference technology. At CD4 counts <350 cells/μl, bias ranged from -35.2 to +13.1 cells/μl while at counts >350 cells/μl, bias ranged from -70.7 to +47 cells/μl, compared to the BD FACSCount as a reference technology. Misclassification around the threshold of 350 c...Continue Reading

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Jan 31, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Roger YingBrian G Williams
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Jan 15, 2019·Journal of the Korean Association of Oral and Maxillofacial Surgeons·Soung Min Kim, Jong Ho Lee
Dec 19, 2019·African Journal of Laboratory Medicine·Daniel RhodesDeborah K Glencross

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Methods Mentioned

BETA
Assay
blood draw
PCA
flow cytometry

Software Mentioned

Pima Analyzer NOW Snap Count
EndNote
Partec CyFlow Counter
FACSCalibur
Pima Analyzer
FACSCount

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