The future role of CD4 cell count for monitoring antiretroviral therapy

Hdl Handle:
http://hdl.handle.net/10144/337728
Title:
The future role of CD4 cell count for monitoring antiretroviral therapy
Authors:
Ford, Nathan; Meintjes, Graeme; Pozniak, Anton; Bygrave, Helen; Hill, Andrew; Peter, Trevor; Davies, Mary-Ann; Grinsztejn, Beatriz; Calmy, Alexandra; Kumarasamy, N; Phanuphak, Praphan; deBeaudrap, Pierre; Vitoria, Marco; Doherty, Meg; Stevens, Wendy; Siberry, George K
Journal:
The Lancet Infectious Diseases
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.
Publisher:
Elsevier
Issue Date:
19-Nov-2014
URI:
http://hdl.handle.net/10144/337728
DOI:
10.1016/S1473-3099(14)70896-5
PubMed ID:
25467647
Language:
en
ISSN:
1474-4457
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorFord, Nathanen_GB
dc.contributor.authorMeintjes, Graemeen_GB
dc.contributor.authorPozniak, Antonen_GB
dc.contributor.authorBygrave, Helenen_GB
dc.contributor.authorHill, Andrewen_GB
dc.contributor.authorPeter, Trevoren_GB
dc.contributor.authorDavies, Mary-Annen_GB
dc.contributor.authorGrinsztejn, Beatrizen_GB
dc.contributor.authorCalmy, Alexandraen_GB
dc.contributor.authorKumarasamy, Nen_GB
dc.contributor.authorPhanuphak, Praphanen_GB
dc.contributor.authordeBeaudrap, Pierreen_GB
dc.contributor.authorVitoria, Marcoen_GB
dc.contributor.authorDoherty, Megen_GB
dc.contributor.authorStevens, Wendyen_GB
dc.contributor.authorSiberry, George Ken_GB
dc.date.accessioned2014-12-30T23:55:59Z-
dc.date.available2014-12-30T23:55:59Z-
dc.date.issued2014-11-19-
dc.identifier.citationThe future role of CD4 cell count for monitoring antiretroviral therapy. 2014: Lancet Infect Disen_GB
dc.identifier.issn1474-4457-
dc.identifier.pmid25467647-
dc.identifier.doi10.1016/S1473-3099(14)70896-5-
dc.identifier.urihttp://hdl.handle.net/10144/337728-
dc.description.abstractFor 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.en_GB
dc.languageENG-
dc.language.isoenen
dc.publisherElsevieren_GB
dc.rightsArchived with thanks to The Lancet Infectious Diseasesen_GB
dc.titleThe future role of CD4 cell count for monitoring antiretroviral therapyen
dc.identifier.journalThe Lancet Infectious Diseasesen_GB

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