CD4 cell count variability with repeat testing in South Africa: Should reporting include both absolute counts and ranges of plausible values?

International Journal of STD & AIDS
Willem Daniel Francois VenterDeborah K Glencross

Abstract

Although eligibility for antiretroviral treatment is no longer based on CD4 thresholds, CD4 testing remains important. Variation in CD4 cell count complicates initiation of antibiotic prophylaxis, differential diagnoses and assessments of immunological recovery. Five hundred and fifty-three HIV-positive antiretroviral-naïve adults, recruited from inner-city clinics, had three serial CD4 cell count tests. Test 1 was mostly done in a laboratory network supporting primary care clinics, while Tests 2 and 3 were performed in a tertiary-level laboratory. Reproducibility was assessed through Bland-Altman limits of agreement and coefficients of variation. Participants, a mean age of 34 years and mostly female (57%), had a median 203 CD4 cells/μL (Test 1). Seventeen per cent classified as having advanced HIV disease (CD4 cell count  < 200 cells/µL) on Test 1 had a CD4 cell count > 200 cells/µL on Tests 2 and 3. Mean differences between tests were <10 cells/µL for all comparisons. Limits of agreement for Tests 1 and 2 were -106.9 to 112.7 and coefficient of variation 15. Corresponding figures for Tests 2 and 3 were -88.2 to 103.4, and 13. Means of tests were similar, suggesting no systematic measurement differences, despite testing being...Continue Reading

References

Nov 1, 1991·Clinical and Experimental Immunology·Y van RoodH van Houwelingen
Jun 1, 1990·Clinical and Experimental Immunology·E BloemenaP T Schellekens
Jun 27, 2003·Cytometry. Part B, Clinical Cytometry·Lesley E ScottDeborah K Glencross
Jul 31, 2007·Lancet·Gary Maartens, Andrew Boulle
Mar 21, 2008·Cytometry. Part B, Clinical Cytometry·Thomas N DennyUNKNOWN NIAID-DAIDS Immunology Quality Assessment Program
Jan 31, 2012·Journal of the International AIDS Society·Deborah K GlencrossRegina Osih
Sep 21, 2013·Journal of the International AIDS Society·Landon MyerLinda-Gail Bekker
Nov 2, 2014·Tropical Medicine & International Health : TM & IH·Clara Calvert, Carine Ronsmans
Jul 26, 2015·BMC Medicine·Lesley E ScottWendy Stevens
Jul 3, 2016·Tropical Medicine & International Health : TM & IH·Greer WaldropNathan Ford
Oct 28, 2016·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Athena P KourtisUNKNOWN Partners in Prevention HSVHIV Transmission Study and Partners PrEP Study Teams
Nov 15, 2016·The Journal of the Association of Nurses in AIDS Care : JANAC·Gema DumitruAmrita Tailor
Aug 24, 2017·BMC Public Health·Helen ReesMatthew F Chersich
Mar 8, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sergio CarmonaWilliam B MacLeod

❮ Previous
Next ❯

Software Mentioned

SIM

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.