Reliability of CD4 quantitation in human immunodeficiency virus-positive children: Implications for definition of immunologic response to highly active antiretroviral therapy

Vincent J. Carey, Savita Pahwa, Adriana Weinberg

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Our objective was to develop data-based algorithms for definition of immunologic response to AIDS therapies in pediatric patients, taking account of T-cell subset measurement errors. The study design involved cross-protocol analysis of 2,148 enrollees in six completed Pediatric AIDS Clinical Trials Group trials. We used standard quantitation of T-cell subsets; linear modeling with mean-dependent measurement error variance was used to develop 95% tolerance limits for change in CD4%. For individuals with a CD4% of approximately 25%, the measurement error-based 95% tolerance interval ranges from 15% to 35%, whereas for individuals with a CD4% of approximately 5%, the tolerance interval ranges from 3% to 7%. When pairs of CD4% measures taken within a time interval of less than 30 days are averaged to estimate steady-state CD4%, tolerance interval width decreases by approximately 30%. A simple graphical tool that provides a data-based criterion for immunologic response over and above variation ascribable to T-cell measurement error is provided. Variability in CD4% due to measurement error is substantial, increases with level of CD4%, and complicates assessment of immunologic response to therapy. Replicates of CD4% measures could be used to improve precision of interpretation of CD4% measures.

Original languageEnglish (US)
Pages (from-to)640-643
Number of pages4
JournalClinical and Diagnostic Laboratory Immunology
Volume12
Issue number5
DOIs
StatePublished - May 1 2005

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Clinical Biochemistry
  • Microbiology (medical)

Fingerprint Dive into the research topics of 'Reliability of CD4 quantitation in human immunodeficiency virus-positive children: Implications for definition of immunologic response to highly active antiretroviral therapy'. Together they form a unique fingerprint.

  • Cite this