Impact of point-of-care CD4 testing on linkage to HIV care: a systematic review

Hdl Handle:
http://hdl.handle.net/10144/312003
Title:
Impact of point-of-care CD4 testing on linkage to HIV care: a systematic review
Authors:
Wynberg, Elke; Cooke, Graham; Shroufi, Amir; Reid, Steven D; Ford, Nathan
Journal:
Journal of the International AIDS Society
Abstract:
Introduction: Point-of-care testing for CD4 cell count is considered a promising way of reducing the time to eligibility assessment for antiretroviral therapy (ART) and of increasing retention in care prior to treatment initiation. In this review, we assess the available evidence on the patient and programme impact of point-of-care CD4 testing. Methods: We searched nine databases and two conference sites (up until 26 October 2013) for studies reporting patient and programme outcomes following the introduction of point-of-care CD4 testing. Where appropriate, results were pooled using random-effects methods. Results: Fifteen studies, mainly from sub-Saharan Africa, were included for review, providing evidence for adults, adolescents, children and pregnant women. Compared to conventional laboratory-based testing, point-of-care CD4 testing increased the likelihood of having CD4 measured [odds ratio (OR) 4.1, 95% CI 3.5-4.9, n=2] and receiving a CD4 result (OR 2.8, 95% CI 1.5-5.6, n=6). Time to being tested was significantly reduced, by a median of nine days; time from CD4 testing to receiving the result was reduced by as much as 17 days. Evidence for increased treatment initiation was mixed. Discussion: The results of this review suggest that point-of-care CD4 testing can increase retention in care prior to starting treatment and can also reduce time to eligibility assessment, which may result in more eligible patients being initiated on ART.
Publisher:
International AIDS Society
Issue Date:
20-Jan-2014
URI:
http://hdl.handle.net/10144/312003
PubMed ID:
24447595
Language:
en
ISSN:
1758-2652
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorWynberg, Elkeen_GB
dc.contributor.authorCooke, Grahamen_GB
dc.contributor.authorShroufi, Amiren_GB
dc.contributor.authorReid, Steven Den_GB
dc.contributor.authorFord, Nathanen_GB
dc.date.accessioned2014-01-28T18:04:23Z-
dc.date.available2014-01-28T18:04:23Z-
dc.date.issued2014-01-20-
dc.identifier.citationImpact of point-of-care CD4 testing on linkage to HIV care: a systematic review. 2014, 17 (1):18809 J Int AIDS Socen_GB
dc.identifier.issn1758-2652-
dc.identifier.pmid24447595-
dc.identifier.urihttp://hdl.handle.net/10144/312003-
dc.description.abstractIntroduction: Point-of-care testing for CD4 cell count is considered a promising way of reducing the time to eligibility assessment for antiretroviral therapy (ART) and of increasing retention in care prior to treatment initiation. In this review, we assess the available evidence on the patient and programme impact of point-of-care CD4 testing. Methods: We searched nine databases and two conference sites (up until 26 October 2013) for studies reporting patient and programme outcomes following the introduction of point-of-care CD4 testing. Where appropriate, results were pooled using random-effects methods. Results: Fifteen studies, mainly from sub-Saharan Africa, were included for review, providing evidence for adults, adolescents, children and pregnant women. Compared to conventional laboratory-based testing, point-of-care CD4 testing increased the likelihood of having CD4 measured [odds ratio (OR) 4.1, 95% CI 3.5-4.9, n=2] and receiving a CD4 result (OR 2.8, 95% CI 1.5-5.6, n=6). Time to being tested was significantly reduced, by a median of nine days; time from CD4 testing to receiving the result was reduced by as much as 17 days. Evidence for increased treatment initiation was mixed. Discussion: The results of this review suggest that point-of-care CD4 testing can increase retention in care prior to starting treatment and can also reduce time to eligibility assessment, which may result in more eligible patients being initiated on ART.en_GB
dc.language.isoenen
dc.publisherInternational AIDS Societyen_GB
dc.rightsArchived with thanks to Journal of the International AIDS Societyen_GB
dc.subjectHIV/AIDSen_GB
dc.titleImpact of point-of-care CD4 testing on linkage to HIV care: a systematic reviewen
dc.identifier.journalJournal of the International AIDS Societyen_GB

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