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

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-posi...

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Bibliographic Details
Published in:International journal of STD & AIDS 2018-10, Vol.29 (11), p.1048-1056
Main Authors: Daniel Francois Venter, Willem, Chersich, Matthew F, Majam, Mohammed, Akpomiemie, Godspower, Arulappan, Natasha, Moorhouse, Michelle, Mashabane, Nonkululeko, Glencross, Deborah K
Format: Article
Language:English
Subjects:
AIDS/HIV
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Summary: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 Tests 2 and 3. Mean differences between tests were
ISSN:0956-4624
1758-1052
DOI:10.1177/0956462418771768