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Journal Article > Commentary

The future role of CD4 cell count for monitoring antiretroviral therapy

Ford NP, Meintjes GA, Pozniak A, Bygrave H, Hill AM, Peter T, Davies MA, Grinsztejn B, Calmy A, Kumarasamy N, Phanuphak P, Debeaudrap P, Vitoria M, Doherty M, Stevens W, Siberry G
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Abstract
For more than two decades, CD4 cell count measurements have been central to understanding HIV disease progression, making important clinical decisions, and monitoring the response to antiretroviral therapy (ART). In well resourced settings, the monitoring of patients on ART has been supported by routine virological monitoring. Viral load monitoring was recommended by WHO in 2013 guidelines as the preferred way to monitor people on ART, and efforts are underway to scale up access in resource-limited settings. Recent studies suggest that in situations where viral load is available and patients are virologically suppressed, long-term CD4 monitoring adds little value and stopping CD4 monitoring will have major cost savings. CD4 cell counts will continue to play an important part in initial decisions around ART initiation and clinical management, particularly for patients presenting late to care, and for treatment monitoring where viral load monitoring is restricted. However, in settings where both CD4 cell counts and viral load testing are routinely available, countries should consider reducing the frequency of CD4 cell counts or not doing routine CD4 monitoring for patients who are stable on ART.
Countries
none
Subject Area
HIV/AIDS
DOI
10.1016/S1473-3099(14)70896-5
Published Date
19-Nov-2014
PubMed ID
25467647
Languages
English
Journal
Lancet Infectious Diseases
Volume / Issue / Pages
Volume 15, Issue 2
Issue Date
01-Feb-2015
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