Exclusion-Based Capture and Enumeration of CD4+ T Cells from Whole Blood for Low-Resource Settings

Alexander L. Howard, Hannah M. Pezzi, David J. Beebe, Scott M. Berry

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


In developing countries, demand exists for a cost-effective method to evaluate human immunodeficiency virus patients' CD4+ T-helper cell count. The TH (CD4) cell count is the current marker used to identify when an HIV patient has progressed to acquired immunodeficiency syndrome, which results when the immune system can no longer prevent certain opportunistic infections. A system to perform TH count that obviates the use of costly flow cytometry will enable physicians to more closely follow patients' disease progression and response to therapy in areas where such advanced equipment is unavailable. Our system of two serially-operated immiscible phase exclusion-based cell isolations coupled with a rapid fluorescent readout enables exclusion-based isolation and accurate counting of T-helper cells at lower cost and from a smaller volume of blood than previous methods. TH cell isolation via immiscible filtration assisted by surface tension (IFAST) compares well against the established Dynal T4 Quant Kit and is sensitive at CD4 counts representative of immunocompromised patients (less than 200 TH cells per microliter of blood). Our technique retains use of open, simple-to-operate devices that enable IFAST as a high-throughput, automatable sample preparation method, improving throughput over previous low-resource methods.

Original languageEnglish
Pages (from-to)313-321
Number of pages9
JournalJournal of laboratory automation
Issue number3
StatePublished - Jun 2014

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this work was provided by a grant from the Bill and Melinda Gates Foundation Grand Challenges in Global Health program. A.L.H. is funded by the National Institutes of Health Chemistry-Biology Interface Predoctoral Training Program (5T32GM008505-20).


  • CD4 count
  • microfluidics
  • point-of-care testing

ASJC Scopus subject areas

  • Computer Science Applications
  • Medical Laboratory Technology


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