Lymphocyte immunophenotype reference ranges in healthy Thai adults: Implications for management of HIV/AIDS in Thailand

Abstract

Lymphocyte immunophenotype reference ranges for T, B, and NK subsets were determined for healthy adult Thais in a multi-center study in Bangkok. Immunophenotyping was by flow cytometry using lysed whole blood. A standard protocol for flow cytometry instrumentation, reagents and quality control was used to minimize site differences and to facilitate comparison of the Thai reference values to those found for Caucasians in previous studies. Major differences were determined for CD3(T), CD4 (T helper/inducer) and CD16+56 (NK) lymphocyte percentages and CD4 lymphocyte absolute counts. Age trends and sex differences were also observed. Compared to Caucasians, Thais, particularly Thai males, had lower CD3 and CD4 T lymphocyte percentages and absolute numbers whereas the percentage of NK lymphocytes was higher. Heterogeneity attributed to biological variation of CD4 T lymphocyte but not other immunophenotype subset distributions was also observed in a well defined geographic population. This study demonstrates the importance of ethnicity, age, sex and possibly environment as factors that influence distribution characteristics of normal lymphocyte immunophenotype reference values. These observations have important implications for the use of lymphocyte subsets - particularly CD3+CD4+ T lymphocyte measurements as applied to HIV disease staging, AIDS definition and the overall clinical management of HIV/AIDS in Thailand.