Absolute Lymphocyte Counts Predict Low CD4 Cell Counts in HIV-Positive Patients

To determine the relation between routinely measured absolute lymphocyte counts (ALCs) and CD4 cell counts, researchers conducted a retrospective chart review of 866 consecutive HIV-positive patients who had ALCs measured in the emergency department and CD4 cell counts measured within 24 hours of admission at a single academic institution during 8 years.

Overall, 85% of patients had low CD4 cell counts (defined as <200×10⁶ cells/µL). ALCs and CD4 cell counts showed a linear association. An ALC <950×10⁶ cells/µL was highly predictive of a CD4 count <200×10⁶ cells/µL (positive likelihood ratio, 10.1). If ALC was >1700×10⁶ cells/µL, a low CD4 count was much less likely (negative likelihood ratio, 0.09).