Journal Article

CD4<sup>+</sup> T-Lymphocyte Count/CD8<sup>+</sup> T-Lymphocyte Count Ratio: Surrogate for HIV Infection in Infants?

Poorana Ganga Devi Navaneethapandian, Ramesh Karunaianantham, Sudha Subramanyan, Ponnuraja Chinnayan, Padmapriyadarsini Chandrasekaran and Soumya Swaminathan

in Journal of Tropical Pediatrics

Volume 58, issue 5, pages 394-397
Published in print October 2012 | ISSN: 0142-6338
Published online January 2012 | e-ISSN: 1465-3664 | DOI: http://dx.doi.org/10.1093/tropej/fmr102
CD4+ T-Lymphocyte Count/CD8+ T-Lymphocyte Count Ratio: Surrogate for HIV Infection in Infants?

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Introduction: Early diagnosis and treatment is necessary to prevent HIV-infected infants progressing to AIDS. Antibody testing is not confirmatory before the age of 18 months and PCR not widely available in resource-poor settings. We studied the accuracy of CD4+ T-lymphocyte count, CD4% and CD4/CD8 ratio as surrogate markers of infant HIV infection.

Methods: Two hundred and fifty-eight HIV-exposed Indian infants at a median age of 5 months (range 1–18) had DNA PCR and CD4, CD8 counts performed.

Results: Fifty five infants tested positive by HIV-1 DNA PCR whereas 203 were negative. Median CD4 count, CD4% and CD4/CD8 ratio were significantly lower in DNA PCR+ infants. Overall sensitivity and specificity of CD4/CD8 ratio <1.0 in predicting HIV was 91 and 92% with a negative predicted value (NPV) and positive predicted value (PPV) of 97 and 76%, respectively.

Conclusion: CD4/CD8 ratio <1.0 is a more sensitive surrogate marker of HIV infection in Indian infants than a CD4 count <1500 cells/µl or CD4% <25%.

Keywords: HIV; infants; surrogate marker; CD4/CD8 ratio; diagnosis

Journal Article.  1428 words.  Illustrated.

Subjects: Paediatrics

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