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Is CD4 monitoring needed among ugandan clients achieving a virologic and immunologic response to treatment?


, : Is CD4 monitoring needed among ugandan clients achieving a virologic and immunologic response to treatment?. Aids Patient Care and Stds 28(11): 575-578

It is unclear whether ongoing CD4 monitoring is needed following immunologic and virologic response to antiretroviral therapy (ART). We investigated the proportion of clients who achieved a virologic and immunologic response and then had a subsequent CD4 count <200 cells/μL despite continued virologic suppression. Included in this analysis were clients receiving ART through the Rakai Health Sciences Program between June 2004-May 2013 who achieved a CD4 ≥200 cells/μL and VL ≤400 copies/mL and who had three sets of CD4 and VL measurements (defined as a sequence) within a 390 day period. A CD4 decline was defined as any drop in CD4 count to <200 cells/μL during a period of viral suppression. A total of 1553 clients were included, 68% females, mean age of 35.5 years (SD 8.3), median baseline CD4 count 183 cells/μL (IQR 106-224). 43 (2.8%) clients developed CD4 declines, the majority, 32/43 (74%), among individuals whose initial CD4 was <300 cells/μL. Of the 43 clients with CD4 declines, 24 had an additional CD4 measurement and 20/24 (83%) achieved a CD4 ≥200 cell/μL on their next measurement (median 285 cells/μL; IQR 220-365). CD4 declines were significantly greater among those with lower CD4 at sequence initiation [adjusted hazard ratio (AHR) 4.3 (95% CI 2.1, 9.0) CD4 200-249 versus ≥350 cells/μL]. Clients who achieved an immunologic and virologic response to ART were unlikely to experience a subsequent CD4 count decline to <200 cells/μL, and among those experiencing a decline, the majority were transient in nature. Thus, ongoing CD4 monitoring could be omitted.

US$19.90

PMID: 25290988

DOI: 10.1089/apc.2014.0086


Other references

Parrot, J., 2008: From self-diagnosis to self-medication: inherent dangers, and impact on pharmacist-patient relationship. Self-medication is not yet very widespread in France, but it is growing, largely because health insurers are no longer covering treatments for minor ailments. The author examines the different situations in which the French self-medicate, and the...

Haschen, R.J., 1977: Diagnostic significance of proteolytic enzymes. Zeitschrift für Medizinische Laboratoriumsdiagnostik 18(3): 147-158

Simounet, C.; Bourgeois, M., 1992: Suicides and attempted suicides by hanging. Annales Medico-Psychologiques 150(7): 481-485

Murray, J.J.; Shaw, L., 1980: A 3-year clinical trial into the effect of fluoride content and toothpaste abrasivity on the caries inhibitory properties of a dentifrice. The effect of reducing the abrasivity of toothpaste on dental caries was observed in a 3-year clinical trial involving 1106 11-13-year-old Berkshire schoolchildren were divided into three groups; Group 1 were allocated a low abrasivity paste conta...

Polizio, A.H.; Gonzales, S.; Muñoz, M.C.; Peña, C.; Tomaro, Mía.L., 2006: Behaviour of the anti-oxidant defence system and heme oxygenase-1 protein expression in fructose-hypertensive rats. 1. Addition of fructose to a rat diet for various periods of time leads to hypertension, hyperinsulinaemia and dyslipidaemia and provides a model for testing oxidative stress parameters in the animals.2. In the present study, oxidative stress gene...

McCarley, T.H., 1986: Can't a practitioner be distinguished?. American Journal of Psychiatry 143(8): 1068-1068

Yu, Y-Ping.; Xu, Q-Qin.; Zheng, M-Zhi.; Wei, E-Qing., 2003: Light transmission measurement of focal ischemic cerebral infarction in mice. OBJECTIVE: To evaluate the feasibility of light transmission to measure focal cerebral ischemia in mice. METHODS: Persistent focal cerebral ischemia was induced by middle cerebral artey occlusion (MCAO) in mice. The brain were removed 24 h after M...

Onzo, A.; Hanna, R.; Zannou, I.; Sabelis, M.W.; Yaninek, J.S., 2003: Dynamics of refuge use: Diurnal, vertical migration by predatory and herbivorous mites within cassava plants. Plants may protect themselves against herbivorous arthropods by providing refuges to predatory arthropods, but they cannot prevent herbivores from taking counter-measures or even from reaping the benefits. To understand whether plants benefit from...

Taşcă, C., 1972: Significance of the size of the cell nucleus in normal and pathological cytophysiology of the endocrine glands. Studii Si Cercetari de Endocrinologie 23(3): 163-174

O'donovan, D.; Hindle, J.E.; Mckeown, S.; O'donovan, S., 1993: Effects of visitors on the behaviour of female cheetahs Acinonyx jubatus and cubs. International Zoo Yearbook 32(0): 238-244