The future role of CD4 cell count for monitoring antiretroviral therapy

Nathan Ford, Graeme Meintjes, Anton Pozniak, Helen Bygrave, Andrew Hill, Trevor Peter, Mary Ann Davies, Beatriz Grinsztejn, Alexandra Calmy, N. Kumarasamy, Praphan Phanuphak, Pierre deBeaudrap, Marco Vitoria, Meg Caroline Doherty, Wendy Stevens, George K. Siberry

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)241-247
Number of pages7
JournalLancet Infectious Diseases
Volume15
Issue number2
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

Fingerprint

CD4 Lymphocyte Count
Viral Load
Physiologic Monitoring
Therapeutics
Cost Savings
Disease Progression
HIV
Guidelines

ASJC Scopus subject areas

  • Infectious Diseases
  • Medicine(all)

Cite this

Ford, N., Meintjes, G., Pozniak, A., Bygrave, H., Hill, A., Peter, T., ... Siberry, G. K. (2015). The future role of CD4 cell count for monitoring antiretroviral therapy. Lancet Infectious Diseases, 15(2), 241-247. https://doi.org/10.1016/S1473-3099(14)70896-5

The future role of CD4 cell count for monitoring antiretroviral therapy. / 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 Caroline; Stevens, Wendy; Siberry, George K.

In: Lancet Infectious Diseases, Vol. 15, No. 2, 01.02.2015, p. 241-247.

Research output: Contribution to journalArticle

Ford, N, Meintjes, G, Pozniak, A, Bygrave, H, Hill, A, Peter, T, Davies, MA, Grinsztejn, B, Calmy, A, Kumarasamy, N, Phanuphak, P, deBeaudrap, P, Vitoria, M, Doherty, MC, Stevens, W & Siberry, GK 2015, 'The future role of CD4 cell count for monitoring antiretroviral therapy', Lancet Infectious Diseases, vol. 15, no. 2, pp. 241-247. https://doi.org/10.1016/S1473-3099(14)70896-5
Ford N, Meintjes G, Pozniak A, Bygrave H, Hill A, Peter T et al. The future role of CD4 cell count for monitoring antiretroviral therapy. Lancet Infectious Diseases. 2015 Feb 1;15(2):241-247. https://doi.org/10.1016/S1473-3099(14)70896-5
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 Caroline ; Stevens, Wendy ; Siberry, George K. / The future role of CD4 cell count for monitoring antiretroviral therapy. In: Lancet Infectious Diseases. 2015 ; Vol. 15, No. 2. pp. 241-247.
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