Normal CD4 Count in Healthy Voluntary Blood Donors in the Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan

Abstract

Aim: This study aimed to estimate the normal CD4 counts in healthy Bhutanese blood donors. Study Design: A prospective descriptive study. Place and Duration of Study: This study was carried out in the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu, between July 2015 to April 2016. Methodology: We recruited healthy blood donors in the JDWNRH collecting demographic characters and blood samples from consenting donors. Blood samples were analyzed using the BD FACS count system. Results: A total of 413 healthy blood donors, 288 (69.7%) males with a mean age of 27.3 years (18-62 years) were enrolled.  Ethnically, 351 (85.0%) were northern and 62 (15.0%) were southern Bhutanese. The mean CD4 count was 668.3 cells/µl (range 259 -1591 cells/µl) and the median was 663 cells/µl.  Females had significantly higher counts (p=0.004) and CD4 counts also significantly increased with increasing age but these differences were numerically small. Ethnicity did not produce significant differences in the CD4 count. In about 21% of the participants, counts were below the reference ranges and published data for Indians and Caucasians but comparable to other Asian, Middle East and African population.  Conclusion: Upon validation with a larger study, a somewhat different CD4 cutoff may be required for the Bhutanese population. However, within the Bhutanese population, a single reference count may be advocated for adults disregarding the negligible numerical differences between age groups and gender.