Performance evaluation of an automated image-based fluorescence CD4+ cell analyzer.

BACKGROUND: Although AIDS-related mortality has declined since the introduction of antiretroviral therapy (ART), HIV/AIDS patients are predominantly present in developing countries that lack high-cost diagnostic devices and human expertise. OBJECTIVE: New methods for counting CD4+ cells cost-effectively are needed to replace conventional flow cytometry-based diagnosis. METHODS: We developed a CD4+ cell analyzer, ADAMII, which is a benchtop fluorescence image-based CD3+/4+ cell counting analyzer. It bears a three-channel light source and performs CD3+/4+ counting assays. The automatic 3D stage captures a maximum of 136 images that are subsequently processed and analyzed using a software integrated into the system. RESULTS: Results obtained using ADAMII were compared with data obtained by conventional methods using a FACSCalibur flow cytometer and the point-of-care PIMA CD4 analyzer. Both comparisons between ADAMII vs. SACS and ADAMII vs. PIMA data yielded a strong correlation with an R-2 value of 0.98, which ensures the feasibility of CD4 test by ADAMII. CONCLUSIONS: The proposed method using ADAMII can be easily employed in resource-limited areas to replace conventional flow cytometers, which are expensive and require highly trained staff.