A North American multilaboratory study of CD4 counts using flow cytometric panleukogating (PLG): A NIAID-DAIDS Immunology Quality Assessment Program Study
| Autor: | Alan L. Landay, Thomas N. Denny, Lee Lam, Thomas J. Spira, Cindy Wilkening, Rebecca Gelman, Frank Mandy, John L. Schmitz, Raul Louzao, Michèle Bergeron, Deborah K. Glencross |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Histology
Quality Assurance Health Care Coefficient of variation Human immunodeficiency virus (HIV) medicine.disease_cause Specimen Handling Pathology and Forensic Medicine Bias Leukocytes medicine Humans Cd4 t cell Quality assessment business.industry Cell Biology Flow Cytometry Blood Cell Count CD4 Lymphocyte Count Cost savings North America Immunology CD4 Lymphocyte Laboratories business Aids pandemic Healthcare system |
| Zdroj: | Cytometry Part B: Clinical Cytometry. :S52-S64 |
| ISSN: | 1552-4957 1552-4949 |
| Popis: | Background The global HIV/AIDS pandemic and guidelines for initiating anti-retroviral therapy (ART) and opportunistic infection prophylaxis demand affordable, reliable, and accurate CD4 testing. A simple innovative approach applicable to existing technology that has been successfully applied in resource-challenged settings, PanLeukogated CD4 (PLG), could offer solutions for cost saving and improved precision. Methods Day-old whole blood from 99 HIV+ donors was simultaneously studied in five North-American laboratories to compare the performance of their predicate methods with the dual-platform PLG method. The predicate technology included varying 4-color CD45/CD3/CD4/CD8 protocols on different flow cytometers. Each laboratory also assayed eight replicate specimens of day-old blood from 10 to 14 local donors. Bias and precision of predicate and PLG methods was studied between- and within-participating laboratories. Results Significantly (P < 0.0001) improved between-laboratory precision/coefficient of variation (CV%) was noted using the PLG method (overall median 9.3% vs. predicate median CV 13.1%). Within-laboratory precision was also significantly (P < 0.0001) better overall using PLG (median 4.6% vs. predicate median CV 6.2%) and in 3 of the 5 laboratories. PLG counts tended to be 11% smaller than predicate methods (P < 0.0001) for shipped (median of predicate—PLG = 31) and local specimens (median of predicate—PLG = 23), both overall and in 4 of 5 laboratories (median decreases of 4, 16, 20, and 21% in shipped specimens); the other laboratory had a median increase of 5%. Conclusion Laboratories using predicate CD4 methods similar to those in this study could improve their between-laboratory and their within-laboratory precision, and reduce costs, by switching to the PLG method after adequate training, if a change (usually, a decrease) in CD4 counts is acceptable to their health systems. © 2008 Clinical Cytometry Society |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text