CD4 Testing Improves HIV Care in Low-and Middle-income Countries

by Colleen Fleiss on  January 16, 2019 at 2:06 AM AIDS/HIV News
RSS Email Print This Page Comment bookmark
Font : A-A+

A practical resource-based public health approach for treating HIV-infected individuals living in low- and middle-income countries could save thousands of lives, stated study published in the open-access journal PLOS Medicine by Mark Tenforde of the University of Washington School of Medicine, and colleagues.
CD4 Testing Improves HIV Care in Low-and Middle-income Countries
CD4 Testing Improves HIV Care in Low-and Middle-income Countries

Several randomized trials have demonstrated benefits from starting antiretroviral therapy regardless of CD4 count, and the World Health Organization adopted a "treat all" strategy in 2015. Significant attention has been focused on rapidly initiating antiretroviral therapy in different settings, and considerable progress has been made. Yet a significant proportion of patients starting antiretroviral therapy in low- and middle-income countries continue to present with severe immunosuppression, with recent laboratory-based surveillance showing that one-third of South African patients enter care with advanced HIV disease. These late presenters have the highest risk for immune reconstitution inflammatory syndrome, unmasking of opportunistic infections including tuberculosis, and death.

According to Tenforde and colleagues, current strategies are inadequate for identifying and preventing opportunistic infections and related deaths in late presenters. The authors present a resource-based approach according to diagnostic test availability for targeting opportunistic infections in the "treat all" era. The approach could decrease early mortality after antiretroviral therapy initiation and would be practical to implement. Even the most resource-constrained settings can implement interventions that have the potential to save thousands of lives, while further refinement can be offered in settings where rapid screening for common opportunistic infections is feasible.

According to the authors, an optimal approach requires that pre-antiretroviral therapy CD4 testing continues to be available (preferably as a simple point-of-care threshold test), although viral load testing has been supplanting CD4 testing in high-burden countries in the "treat all" era. "We believe this provides a pragmatic algorithm to avoid delaying antiretroviral therapy for the most immunosuppressed patients who are at the highest risk of dying," the authors write.

Source: Eurekalert

Post a Comment

Comments should be on the topic and should not be abusive. The editorial team reserves the right to review and moderate the comments posted on the site.
Notify me when reply is posted
I agree to the terms and conditions
Advertisement

Recommended Reading

More News on:

Oral Health And AIDS AIDS/HIV AIDS/HIV - Epidemiology AIDS/HIV - Clinical Features AIDS/HIV - Health Education AIDS/HIV - Prevention And Transmission AIDS / HIV - Treatment AIDS/HIV- Lab Tests and Faqs Prostitution: Fresh Stakes in the Oldest Trade HIV Symptom 

News A - Z

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

News Search

Medindia Newsletters

Subscribe to our Free Newsletters!

Terms & Conditions and Privacy Policy.

Find a Doctor

Stay Connected

  • Available on the Android Market
  • Available on the App Store

News Category

News Archive