Monitoring individuals with HIV infection/AIDS requires the use of expensive tools, which are not readily available in resource-limited settings. The high cost of CD4 count estimation in resource-limited countries is a major challenge in initiating patients on highly active antiretroviral therapy (HAART). This study was initiated to ascertain the reliability of total lymphocyte count as a substitute for CD4 cell count in indigenous areas. 451 patients who had visited the clinic in FMC, Owo (HIV counseling and testing (HCT) unit and the global HIV/AIDS Initiative Nigeria (GHAIN)-Supported laboratory), between July 2014 and August 2015 were randomly recruited in this prospective cross sectional study. The recruited subjects were analyzed for CD4 counts & TLC to determine the correlation between TLC and CD4 cell counts. Spearman correlation between TLC and CD4 cell count were determined. Sensitivity, specificity, positive and negative predictive values of different TLC values was computed for CD4 count ≤200 and ≤350 cell/mm3. This study showed positively significant correlation between TLC and CD4 counts and also it revealed reasonably adequate sensitivity and specificity to consider TLC as a substitute for CD4 count. Thus, TLC may be helpful in deciding when to initiate antiretroviral therapy and thus acts as a surrogate marker for CD4 counts in resource-poor settings.
