Abstract
Introduction: To determine the possibility of utilizing total lymphocyte counts (TLC) instead of
CD4 counts in the initiation and management of patients with HIV on highly active antiretroviral
therapy (HAART). The commencement of HAART CD4 lymphocytes has been employed in the
management HIV. However it has been found that determination of CD4 counts is expensive and
somewhat laborious to perform in already overburdened healthcare systems especially in the developing
countries. Methodology: Five hundred and three (503) consenting patients already on
HAART (commenced at CD4 count < 350 cells/?l) who attended our HIV clinic between February
2014 and February 2015 were enrolled into the study. The patients had already been diagnosed as
HIV positive. Kappa statistic was computed as a measure of reliability of TLC. Various cut-off
marks for TLC in respect of the CD4 counts were determined in addition to the computation of
both sensitivity and specificity. Receiver operating curves (ROC), showing area under the curve
indicating agreement in classification, were plotted. Results: Majority of patients were female
(73.8%). Most of the patients were in the age range of 25 - 34 years (37.2%). Males were found to
*Corresponding author.
B. E. Egbewale et al.
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be significantly older than females (P < 0.05). Area under the receiver operating curves (ROC) revealed
that 4 out of 10 patients would be missed using total lymphocyte count (TLC) as the indicator
for commencement of HAART. A low correlation coefficient and Kappa statistic r = 0.18, and K
= 0.20 respectively, were observed between TLCs and CD4 counts. Conclusion: Total lymphocyte
count is not a suitable alternative to CD4 counts in the management of HIV/AIDS.