Absolute Lymphocyte Count as a Complementary Marker of Immunological Status in People Living with HIV/AIDS
DOI:
https://doi.org/10.37287/ijghr.v8i6.2822Keywords:
absolute lymphocyte count, biomarker, cd4 count, disease progression, HIV/AIDSAbstract
Monitoring HIV/AIDS disease progression primarily relies on CD4 cell count and viral load testing. Limited access to these assessments in resource-constrained settings highlights the need for simple and accessible biomarkers. Absolute lymphocyte count (ALC) is routinely measured and may provide additional information on immune status. To assess the association between ALC and CD4 cell count and evaluate its ability to identify advanced immunosuppression among people living with HIV/AIDS. A cross-sectional analytical observational study was conducted among people living with HIV/AIDS receiving care at Dr. M. Djamil Hospital, Padang, Indonesia, from May to September 2026. A total of 196 participants were recruited consecutively. ALC was measured using an automated haematology analyser and CD4 count by flow cytometry. Correlation, multiple linear regression, and receiver operating characteristic (ROC) analyses were performed. Of 196 participants, 20.4% had CD4 counts <200 cells/µL. Mean CD4 and ALC were 316.95 and 1,954.38 cells/µL, respectively. ALC was positively correlated with CD4 count (r = 0.567; p < 0.001) and remained significantly associated after adjustment (B = 0.051; β = 0.315; p = 0.008). ROC analysis showed good discrimination (AUC = 0.925; 95% CI, 0.845–1.00; p = 0.001). The optimal cut-off was 2,072.9 cells/µL, with 54.8% sensitivity and 95.2% specificity. ALC may serve as a complementary indicator of immunological status, particularly where CD4 testing is limited.
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