Predictors of low CD4 count in resource-limited settings : Based on an antiretroviral-naive heterosexual Thai population

Caroline Costello; Kenrad E Nelson; Denise J Jamieson; Lisa Spacek; Supaluk Sennun; Sodsai Tovanabutra; Kittipong Rungruengthanakit; Vinai Suriyanon; Ann Duerr

doi:10.1097/01.qai.0000152397.67638.4a

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Predictors of low CD4 count in resource-limited settings : Based on an antiretroviral-naive heterosexual Thai population

Journal article

Peer reviewed

Predictors of low CD4 count in resource-limited settings : Based on an antiretroviral-naive heterosexual Thai population

Caroline Costello, Kenrad E Nelson, Denise J Jamieson, Lisa Spacek, Supaluk Sennun, Sodsai Tovanabutra, Kittipong Rungruengthanakit, Vinai Suriyanon and Ann Duerr

Journal of acquired immune deficiency syndromes (1999), Vol.39(2), pp.242-248

06/01/2005

DOI: 10.1097/01.qai.0000152397.67638.4a

PMID: 15905742

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Abstract

A barrier to the appropriate provision of antiretroviral therapy to treat immunosuppressed HIV-infected persons in resource-poor countries is identifying who requires treatment. The World Health Organization (WHO) has suggested using a clinical algorithm combined with a total lymphocyte count (TLC) < 1200 cells/mm as a surrogate for a CD4 count less than 200 cells/mm when it is not possible to measure the CD4 count. We evaluated various TLC levels, anemia, and body mass index and compared our data with the WHO criteria to develop a more sensitive algorithm to predict CD4 counts of < 200 cells/mm and < 350 cells/mm in 839 men and women from Thailand infected with HIV-1 subtype E (CRF01_AE). The December 2003 WHO guidelines had a sensitivity of 34.1% in men and 31.8% in women to detect persons with a CD4 count < 200 cells/mm in this HIV-infected population from Thailand. The use of a TLC < 1500 cells/mm or TLC < 2000 cells/mm combined with anemia or WHO stage II infection doubled the sensitivity to detect persons with a CD4 count < 200 (63.0% in men, 68.2% in women) with less than a 6% decrease in specificity.

Infectious Diseases

Microbiology

Virology

Biological and medical sciences

Fundamental and applied biological sciences. Psychology

Human viral diseases

Medical sciences

Miscellaneous

Viral diseases

Details

Title: Subtitle: Predictors of low CD4 count in resource-limited settings : Based on an antiretroviral-naive heterosexual Thai population
Creators: Caroline Costello - Centers for Disease Control and Prevention
Kenrad E Nelson - Johns Hopkins University
Denise J Jamieson - Centers for Disease Control and Prevention
Lisa Spacek - Johns Hopkins University
Supaluk Sennun - Marine Acoustics
Sodsai Tovanabutra - Henry M. Jackson Foundation
Kittipong Rungruengthanakit - Marine Acoustics
Vinai Suriyanon - Marine Acoustics
Ann Duerr - Centers for Disease Control and Prevention
Resource Type: Journal article
Publication Details: Journal of acquired immune deficiency syndromes (1999), Vol.39(2), pp.242-248
Publisher: Lippincott Williams & Wilkins
DOI: 10.1097/01.qai.0000152397.67638.4a
PMID: 15905742
ISSN: 1525-4135
eISSN: 1944-7884
Language: English
Date published: 06/01/2005
Academic Unit: Obstetrics and Gynecology; VPMA - Administration
Record Identifier: 9984446430202771

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