World Journal of AIDS, 2021, 11, 181-188
https://www.scirp.org/journal/wja
ISSN Online: 2160-8822
ISSN Print: 2160-8814
DOI: 10.4236/wja.2021.114013 Dec. 28, 2021 181 World Journal of AIDS
Factors Associated with Sample Rejection
for CD4+/CD8+ T Cell Count Analyses at the
Kenyatta National Hospital Comprehensive
Care Center Laboratory, Kenya
Moherai Wilfred Felix
1
, Joshua Nyagol
1*
, Walter Mwanda
2
1
Department of Human Pathology, Thematic Unit of Immunology, University of Nairobi, Nairobi, Kenya
2
Department of Human Pathology, Thematic Unit of Hematology and Blood Transfusion Unit, University of Nairobi, Nairobi, Kenya
Abstract
Background: The appropriate time to initiate antiretroviral therapy (ART) in
HIV/AIDS patients is determined by measurement of CD4+/CD8+ T cell
count. The CD4/CD8+ T cell count is also useful, together with viral load, in
monitoring disease progression and effectiveness treatment regimens. Several
factors may contribute to sample rejection during the CD4+/CD8+ T cells
count, resulting in negative effects on patient management. Objective: Eva-
luate the causes for CD4+CD8+ T cell count sample rejection at the Kenyatta
National Hospital Comprehensive Care Center Laboratory. Method: A re-
trospective cross-sectional study was conducted between 2018 and 2020. Data
was obtained from the “rejected samples” for Partec
R
FlowCyp flow cytome-
try file. Designed data collection sheet was used for data capture. A total of
3972 samples were submitted for CD4+/CD8+ T cell count during the study
period. Causes for sample rejection were numbered 1 to 12, each representing
a reason for sample rejection. Number 1 was sub-categorized into clotted,
hemolyzed, short-draw and lipemic. Data was analyzed using excel, and pre-
sented using tables, graphs and pie charts. Approval to conduct the study was
obtained from KNH/UoN ERC. Results: In the study period, 81/3972 (2.0%)
samples were rejected. Samples submitted more than 48 hours after collection
were mostly rejected. Other factors included improper collection technique,
delayed testing, patient identification error and incorrect use of vacutainer. A
combination of clotted samples, specimen submission more than 48 hours
caused the most frequent sample rejection, followed with combination of spe-
cimen submission more than 48 hours, delayed testing and delayed specimen
processing. Together, clotted samples, incorrect vacutainer and poor speci-
men label caused the least sample rejection. Conclusion: Sample rejection
How to cite this paper: Felix, M.W., Nya-
gol, J. and Mwanda, W. (2021) Factors As-
sociated with Sample Rejection for CD4+/
CD8+ T Cell Count Analyses at the Kenyatta
National Hospital Comprehensive Care Cen-
ter Laboratory, Kenya. World Journal of
AIDS, 11, 181-188.
https://doi.org/10.4236/wja.2021.114013
Received: October 20, 2021
Accepted: December 25, 2021
Published: December 28, 2021
Copyright © 2021 by author(s) and
Scientific Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access