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- Document 0999
- DOCN M9650999
- TI Potential clinical implications of interlaboratory variability in CD4+
- T-lymphocyte counts of patients infected with human immunodeficiency
- virus.
- DT 9505
- AU Sax PE; Boswell SL; White-Guthro M; Hirsch MS; Infectious Disease
- Division, Brigham and Women's Hospital,; Boston, Massachusetts 02115,
- USA.
- SO Clin Infect Dis. 1995 Nov;21(5):1121-5. Unique Identifier : AIDSLINE
- MED/96125992
- AB The CD4+ T-lymphocyte count is an important factor in the management of
- patients infected with human immunodeficiency virus. Previous studies
- have found significant variability among the counts determined by
- different laboratories. We conducted a study of lymphocyte phenotyping
- in four laboratories to assess this variability and its possible
- clinical implications. One laboratory was situated at the study site;
- the other three were selected randomly from a total of 11 commercial and
- hospital laboratories available locally. Blood specimens were obtained
- from 24 patients and were sent to the four laboratories for a complete
- blood count and a lymphocyte subset analysis. Using the Kruskall-Wallis
- test, we found that the laboratories' ranks of four individual
- components of the CD4 cell count differed significantly: total white
- blood cell count (P < .0001), lymphocyte percentage (P = .003),
- lymphocyte count (P = .002), and CD4 percentage (P = .0004). Of the 24
- patients in this survey, 14 (58.3%) had CD4-count results with enough
- variation to have led to conflicting treatment recommendations; three of
- the 24 patients fulfilled the revised Centers for Disease Control and
- Prevention case definition of AIDS on the basis of results from some but
- not all laboratories. In addition, the laboratories disagreed on whether
- CD4 cell counts of nine patients (37.5%) had increased or decreased
- since the previous determination. We conclude that when strict
- thresholds of CD4 cell counts are used as a basis for treatment
- recommendations or for diagnosis of AIDS, interlaboratory variability
- may be sufficient to alter the decisions made.
- DE Acquired Immunodeficiency Syndrome/DIAGNOSIS/IMMUNOLOGY Analysis of
- Variance *CD4 Lymphocyte Count Female Human HIV
- Infections/CLASSIFICATION/*IMMUNOLOGY/THERAPY Laboratories Male
- Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE
-
- SOURCE: National Library of Medicine. NOTICE: This material may be
- protected by Copyright Law (Title 17, U.S.Code).
-
-