Skip to main content
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1986 May 1;134(9):1013–1017.

Diagnostic utility of lymphocyte subset analysis in AIDS case finding.

W J Boyko, M T Schechter, A MacLeod, B Douglas, M Maynard, R Sharp, B Wiggs
PMCID: PMC1491019  PMID: 2938707

Abstract

Abnormalities of lymphocyte subsets, especially low absolute number of helper T cells, are characteristically present in acquired immune deficiency syndrome (AIDS). Similar abnormalities can be found in patients with persistent generalized lymphadenopathy (PGL) or AIDS-related complex (ARC) and, to a lesser degree, in asymptomatic people who have been exposed to human T-lymphotropic virus type III (HTLV-III). Nevertheless, there appears to be a widespread perception that lymphocyte subset analysis may be useful in AIDS case finding within high-risk groups. We evaluated the diagnostic utility of absolute number of helper T cells and ratio of helper to suppressor T cells in 33 patients with AIDS, 43 patients with PGL who had been referred for lymph node biopsy, 90 patients with PGL and 195 male homosexual controls. At conventional cutoff levels the tests did not appear to revise the probability of AIDS upward to any clinically significant degree when the pretest probability of AIDS was low. Lymphocyte subset analysis does not appear to be a cost-effective method of AIDS case finding in identified groups at risk in which the prevalence of AIDS is low.

Full text

PDF
1013

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abrams D. I., Lewis B. J., Beckstead J. H., Casavant C. A., Drew W. L. Persistent diffuse lymphadenopathy in homosexual men: endpoint or prodrome? Ann Intern Med. 1984 Jun;100(6):801–808. doi: 10.7326/0003-4819-100-6-801. [DOI] [PubMed] [Google Scholar]
  2. Ammann A. J., Abrams D., Conant M., Chudwin D., Cowan M., Volberding P., Lewis B., Casavant C. Acquired immune dysfunction in homosexual men: immunologic profiles. Clin Immunol Immunopathol. 1983 Jun;27(3):315–325. doi: 10.1016/0090-1229(83)90084-3. [DOI] [PubMed] [Google Scholar]
  3. Boyko W. J., Schechter M. T., Jeffries E., Douglas B., Maynard M., O'Shaughnessy M. The Vancouver Lymphadenopathy-AIDS Study: 3. Relation of HTLV-III seropositivity, immune status and lymphadenopathy. Can Med Assoc J. 1985 Jul 1;133(1):28–32. [PMC free article] [PubMed] [Google Scholar]
  4. Carney W. P., Rubin R. H., Hoffman R. A., Hansen W. P., Healey K., Hirsch M. S. Analysis of T lymphocyte subsets in cytomegalovirus mononucleosis. J Immunol. 1981 Jun;126(6):2114–2116. [PubMed] [Google Scholar]
  5. Cavaille-Coll M., Messiah A., Klatzmann D., Rozenbaum W., Lachiver D., Kernbaum S., Brisson E., Chapuis F., Blanc C., Debre P. Critical analysis of T cell subset and function evaluation in patients with persistent generalized lymphadenopathy in groups at risk for AIDS. Clin Exp Immunol. 1984 Sep;57(3):511–519. [PMC free article] [PubMed] [Google Scholar]
  6. De Waele M., Thielemans C., Van Camp B. K. Characterization of immunoregulatory T cells in EBV-induced infectious mononucleosis by monoclonal antibodies. N Engl J Med. 1981 Feb 19;304(8):460–462. doi: 10.1056/NEJM198102193040804. [DOI] [PubMed] [Google Scholar]
  7. Fahey J. L., Prince H., Weaver M., Groopman J., Visscher B., Schwartz K., Detels R. Quantitative changes in T helper or T suppressor/cytotoxic lymphocyte subsets that distinguish acquired immune deficiency syndrome from other immune subset disorders. Am J Med. 1984 Jan;76(1):95–100. doi: 10.1016/0002-9343(84)90756-3. [DOI] [PubMed] [Google Scholar]
  8. Gilmore N. J., Prchal J. F., Jothy S. Persistent generalized lymphadenopathy in homosexual men: clinical, pathological and immunologic characteristics. Can Med Assoc J. 1983 Nov 1;129(9):960–965. [PMC free article] [PubMed] [Google Scholar]
  9. Gold J. W., Weikel C. S., Godbold J., Garcia C., Urmacher C., Cunningham-Rundles S., Koziner B., Pollack M., Gallo R. C., Sarngadharan M. G. Unexplained persistent lymphadenopathy in homosexual men and the acquired immune deficiency syndrome. Medicine (Baltimore) 1985 May;64(3):203–213. doi: 10.1097/00005792-198505000-00005. [DOI] [PubMed] [Google Scholar]
  10. Gottlieb M. S., Schroff R., Schanker H. M., Weisman J. D., Fan P. T., Wolf R. A., Saxon A. Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. N Engl J Med. 1981 Dec 10;305(24):1425–1431. doi: 10.1056/NEJM198112103052401. [DOI] [PubMed] [Google Scholar]
  11. Hersh E. M., Mansell P. W., Reuben J. M., Frank J., Rios A., LaPushin R., Newell G. Suppressor cell activity among the peripheral blood leukocytes of selected homosexual subjects. Cancer Res. 1983 Apr;43(4):1905–1909. [PubMed] [Google Scholar]
  12. Kalish S. B., Ostrow D. G., Goldsmith J., Hsu C. C., Chmiel J. S., Wallemark C. B., Phair J. P. The spectrum of immunologic abnormalities and clinical findings in homosexually active men. J Infect Dis. 1984 Feb;149(2):148–156. doi: 10.1093/infdis/149.2.148. [DOI] [PubMed] [Google Scholar]
  13. Kornfeld H., Vande Stouwe R. A., Lange M., Reddy M. M., Grieco M. H. T-lymphocyte subpopulations in homosexual men. N Engl J Med. 1982 Sep 16;307(12):729–731. doi: 10.1056/NEJM198209163071206. [DOI] [PubMed] [Google Scholar]
  14. Mathur-Wagh U., Enlow R. W., Spigland I., Winchester R. J., Sacks H. S., Rorat E., Yancovitz S. R., Klein M. J., William D. C., Mildvan D. Longitudinal study of persistent generalised lymphadenopathy in homosexual men: relation to acquired immunodeficiency syndrome. Lancet. 1984 May 12;1(8385):1033–1038. doi: 10.1016/s0140-6736(84)91449-1. [DOI] [PubMed] [Google Scholar]
  15. Mildvan D., Mathur U., Enlow R. W., Romain P. L., Winchester R. J., Colp C., Singman H., Adelsberg B. R., Spigland I. Opportunistic infections and immune deficiency in homosexual men. Ann Intern Med. 1982 Jun;96(6 Pt 1):700–704. doi: 10.7326/0003-4819-96-6-700. [DOI] [PubMed] [Google Scholar]
  16. Pinching A. J., McManus T. J., Jeffries D. J., Moshtael O., Donaghy M., Parkin J. M., Munday P. E., Harris J. R. Studies of cellular immunity in male homosexuals in London. Lancet. 1983 Jul 16;2(8342):126–130. doi: 10.1016/s0140-6736(83)90115-0. [DOI] [PubMed] [Google Scholar]
  17. Rogers M. F., Morens D. M., Stewart J. A., Kaminski R. M., Spira T. J., Feorino P. M., Larsen S. A., Francis D. P., Wilson M., Kaufman L. National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 2. Laboratory results. Ann Intern Med. 1983 Aug;99(2):151–158. doi: 10.7326/0003-4819-99-2-151. [DOI] [PubMed] [Google Scholar]
  18. Schechter M. T., Boyko W. J., Jeffries E., Willoughby B., Nitz R., Constance P. The Vancouver Lymphadenopathy-AIDS Study: 1. Persistent generalized lymphadenopathy. Can Med Assoc J. 1985 Jun 1;132(11):1273–1279. [PMC free article] [PubMed] [Google Scholar]
  19. Schechter M. T., Sheps S. B. Diagnostic testing revisited: pathways through uncertainty. Can Med Assoc J. 1985 Apr 1;132(7):755–760. [PMC free article] [PubMed] [Google Scholar]
  20. Schroff R. W., Gottlieb M. S., Prince H. E., Chai L. L., Fahey J. L. Immunological studies of homosexual men with immunodeficiency and Kaposi's sarcoma. Clin Immunol Immunopathol. 1983 Jun;27(3):300–314. doi: 10.1016/0090-1229(83)90083-1. [DOI] [PubMed] [Google Scholar]
  21. Simmons K. Caffeine opens airways for asthmatics. JAMA. 1984 Jan 27;251(4):441–441. [PubMed] [Google Scholar]
  22. Stahl R. E., Friedman-Kien A., Dubin R., Marmor M., Zolla-Pazner S. Immunologic abnormalities in homosexual men. Relationship to Kaposi's sarcoma. Am J Med. 1982 Aug;73(2):171–178. doi: 10.1016/0002-9343(82)90174-7. [DOI] [PubMed] [Google Scholar]
  23. deShazo R. D., Penico J. P., Pankey G. A., Nordberg J. A., Newton J. L., Bozelka B., Cortez L. M., Dalovisio J. R. Studies in homosexual patients with and without lymphadenopathy. Relationships to the acquired immune deficiency syndrome. Arch Intern Med. 1984 Jun;144(6):1153–1158. [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES