POPLINE Document Number: 194597
Author(s):
Ferris DC
Dawood H
Magula NP
Lalloo UG
Source citation:
AIDS, 2004 Jul;18(10):1481-1488.
Abstract:
We welcome the attempt by Spacek et al. to develop a practical, accurate, and less expensive alternative to universal CD4 lymphocyte testing to guide the initiation of potent antiretroviral therapy in resource-limited settings. In South Africa the government has recently announced its intention to provide antiretroviral treatment for individuals with HIV and AIDS. We are aware that the Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment for South Africa calls for the initiation of antiretroviral treatment based on clinical assessment and CD4 lymphocyte count. However, universal CD4 lymphocyte testing in South Africa will require substantial upgrading of the current nationwide capacity. Therefore, we investigated the utility of the algorithm of Spacek et al. in our own clinic setting. As flow cytometry is available in South Africa, we chose to apply method II in their paper. Using this algorithm, patients with total lymphocyte counts of less than 1200 cells/mm/3 are predicted to have CD4 lymphocyte counts of less than 200 cells/mm/3; patients with total lymphocyte counts of 1200 cells/mm/3 or greater and hemoglobin levels less than 12 g/dl require CD4 lymphocyte testing; and patients with total lymphocyte counts of 1200 cells/mm/3 or greater and hemoglobin levels of 12 g/dl or greater are considered to have CD4 lymphocyte counts of 200 cells/mm/3 or greater. We conducted a retrospective review of patients’ charts at the King Edward VIII Hospital Family Clinic, a public sector, tertiary care referral HIV/AIDS Clinic in Durban, KwaZulu, Natal, where potent antiretroviral therapy is still inaccessible to the majority, but where CD4 lymphocyte counts and full blood counts are performed routinely. (excerpt)
Keywords:
South AfricaIndex page
Research Report
Clinical Research
HIV Positive Persons
HIV Testing
Immunity, Cellular
Antiretroviral Therapy
Laboratory Examinations and Diagnoses
Africa, Southern
Africa, Sub Saharan
Africa
Developing Countries
Research Methodology
HIV Infections
Viral Diseases
Diseases
Examinations and Diagnoses
Immunity
Immune System
Physiology
Biology
HIV