scholarly journals CD4 Cell Counts at HIV Diagnosis among HIV Outpatient Study Participants, 2000–2009

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Kate Buchacz ◽  
Carl Armon ◽  
Frank J. Palella ◽  
Rose K. Baker ◽  
Ellen Tedaldi ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Population Level ◽  
Cd4 Count ◽  
Hiv Diagnosis ◽  
Cell Counts ◽  
Late Hiv Diagnosis ◽  
Cd4 Cell Counts ◽  
The Usa ◽  
Study Participants ◽  
Cd4 Cell

Background. It is unclear if CD4 cell counts at HIV diagnosis have improved over a 10-year period of expanded HIV testing in the USA.Methods. We studied HOPS participants diagnosed with HIV infection ≤6 months prior to entry into care during 2000–2009. We assessed the correlates of CD4 count <200 cells/mm3at HIV diagnosis (late HIV diagnosis) by logistic regression.Results. Of 1,203 eligible patients, 936 (78%) had a CD4 count within 3 months after HIV diagnosis. Median CD4 count at HIV diagnosis was 299 cells/mm3and did not significantly improve over time (P=0.13). Comparing periods 2000-2001 versus 2008-2009, respectively, 39% and 35% of patients had a late HIV diagnosis (P=0.34). Independent correlates of late HIV diagnosis were having an HIV risk other than being MSM, age ≥35 years at diagnosis, and being of nonwhite race/ethnicity.Conclusions. There is need for routine universal HIV testing to reduce the frequency of late HIV diagnosis and increase opportunity for patient- and potentially population-level benefits associated with early antiretroviral treatment.

scholarly journals Does community-based point of care HIV testing reduce late HIV diagnosis? A retrospective study in England and Wales

2017 ◽  
Vol 28 (11) ◽  
pp. 1098-1105 ◽  
Author(s):  
Nell Freeman-Romilly ◽  
Paula Sheppard ◽  
Sarika Desai ◽  
Nick Cooper ◽  
Michael Brady
Keyword(s):  
Hiv Testing ◽  
Cell Count ◽  
Point Of Care ◽  
Community Settings ◽  
Hiv Diagnosis ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Hiv Test ◽  
Cd4 Cell

The objective of this study was to investigate if patients diagnosed in community clinics have higher baseline CD4 cell counts than those diagnosed in Genitourinary medicine (GUM)/HIV clinics. We undertook a retrospective review of baseline CD4 cell counts for patients receiving a reactive HIV test in community-testing clinics. Eleven local HIV clinics were contacted to determine the baseline CD4 cell counts of these patients. Baseline CD4 cell counts of those diagnosed in the community were compared with mean local GUM/HIV clinic and median national baseline CD4 cell count for their year of diagnosis. Clients diagnosed in community settings had a mean baseline CD4 cell count of 481 cells/mm3 (SD 236 cells/mm3) and median baseline of 483 cells/mm3 (interquartile range 311–657 cells/mm3). This was significantly higher than those diagnosed in the GUM/HIV clinic local to the community-testing site (mean baseline CD4 397 cells/mm3, p = 0.014) and the national median for that year (336 cells/mm3, p < 0.001). HIV testing in community settings identifies patients at an earlier stage of infection than testing in clinical settings.

Causes and outcomes of hospitalizations among people living with HIV in Georgia’s referral institution, 2012–2017

2021 ◽  
Vol 32 (7) ◽  
pp. 662-670
Author(s):  
Nino Rukhadze ◽  
Ole Kirk ◽  
Nikoloz Chkhartishvili ◽  
Natalia Bolokadze ◽  
Lali Sharvadze ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Clinical Immunology ◽  
Fatal Outcome ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Lethal Outcome ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Living With Hiv ◽  
Cd4 Cell

We assessed trends in causes and outcomes of hospitalization among people living with HIV (PLWH) admitted to the Infectious Diseases, AIDS and Clinical Immunology Research Center (IDACIRC) in Tbilisi, Georgia. Retrospective analysis included adult PLWH admitted to IDACIRC for at least 24 h. Internationally validated categorization was used to split AIDS admissions into mild, moderate, and severe AIDS. A total of 2085 hospitalizations among 1123 PLWH were registered over 2012–2017 with 65.1% (731/1123) of patients presenting with CD4 count <200. Of 2085 hospitalizations, 931 (44.7%) were due to AIDS-defining illnesses. In 2012, AIDS conditions accounted for 50.3% of admissions compared to 41.6% in 2017 ( p = 0.16). Overall, 167 hospitalizations (8.0%) resulted in lethal outcome. AIDS admissions had higher mortality than non-AIDS admissions (11.5% vs 5.2%, p < 0.0001). Among 167 deceased patients, 137 (82.0%) had CD4 count <200 at admission. In multivariate analysis, factors significantly associated with mortality included severe AIDS versus non-AIDS admission (OR 2.81, 95% CI: 1.10–7.15), CD4 cell counts <50 (OR 4.34, 95% CI: 2.52–7.47), and 50–100 (OR 2.37, 95% CI: 1.27–4.42) versus >200. Active AIDS disease remains a significant cause of hospitalization and fatal outcome in Georgia. Earlier diagnosis of HIV is critical for decreasing AIDS hospitalizations and mortality.

scholarly journals The correlation of tuberculosis smear results and immuno-suppression with CD4+ counts as a surrogate marker among HIV infected patients.

2021 ◽  
Author(s):  
Kingsley Kamvuma ◽  
Yusuf ademola ◽  
Warren Chanda ◽  
Christopher Newton Phiri ◽  
Sam Bezza Phiri ◽  
...  
Keyword(s):  
Cell Count ◽  
Surrogate Marker ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Cd4 Cell Count ◽  
Cd4 Counts ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Study Participants ◽  
Cd4 Cell

Abstract Background: Human immunodeficiency virus (HIV) and M.tuberculosis are two intracellular pathogens that interact at the cellular, clinical and population levels. Since the recognition of AIDS in 1981, the number of reported cases of TB in the has increased substantially, especially in regions with high incidence of AIDS. The main aim of this study was to establish weather there is a relationship between sputum smear positives and low CD4 cell counts among HIV infected patients.Materials and methods: This was a retrospective study involving 473 participants. The patients recruited in this study were those who tested HIV positive and smear positive for TB. Their HIV status was determined by performing an HIV blood test, if they were HIV positive their CD4 cell count were then made.Results: This study examined the relation between smear positivity and low CD4 (below 200cells/µl) together with CD8 and CD3 markers as a measure of immune function among patients infected with HIV. The study participants’ constituted males 67% and females 33%. The overall mean age was 33.2 (SD 6.9) with the youngest and oldest participants being 18 and 60 respectively. It was found that smear positive results negatively (r=-0.13; p=0.021) correlated with CD4+ below 200 cells/µl. No correlation was observed between smear positives and CD8+ or CD3+ since the calculated correlation coefficient was not significant 0.007 (p=0.9) and 0.03 (p=0.6) respectively. There are more 3+ smear results below 200 cells/µl than the others while above 200 cells/µl 1+ was the most commonly reported smear result. The scanty smear positives were the least commonly reported result in the low and high CD4 counts. Conclusion: The smear positive result negatively correlated with a low CD4+ (r=-0.13; p=0.021) but no correlation with low CD+8 and CD+3 results was observed. The long held theory that low bacillary counts in patients with low CD4+ counts needs to be revisited. The reduction of CD4+ cell count parallels' that of the total lymphocyte count and is more marked in patients with high bacillary counts. Further, studies are required to confirm these findings

scholarly journals SCID genotype and 6-month posttransplant CD4 count predict survival and immune recovery

Blood ◽  
2018 ◽  
Vol 132 (17) ◽  
pp. 1737-1749 ◽  
Author(s):  
Elie Haddad ◽  
Brent R. Logan ◽  
Linda M. Griffith ◽  
Rebecca H. Buckley ◽  
Roberta E. Parrott ◽  
...  
Keyword(s):  
Immune Reconstitution ◽  
Cd4 Count ◽  
Immune Recovery ◽  
Term Survival ◽  
Long Term Survival ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Key Points ◽  
Cd4 Cell

Key Points The genetic cause of SCID impacts on survival and immune reconstitution and should be considered in tailoring HCT for individual patients. Total and naive CD4+ cell counts in SCID patients 6 and 12 months post-HCT predict long-term survival and sustained immune reconstitution.

scholarly journals Factors related to baseline CD4 cell counts in HIV/AIDS patients: comparison of poisson, generalized poisson and negative binomial regression models

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Maryam Farhadian ◽  
Younes Mohammadi ◽  
Mohammad Mirzaei ◽  
Nasrin Shirmohammadi-Khorram
Keyword(s):  
Regression Models ◽  
Negative Binomial ◽  
Clinical Stage ◽  
Negative Binomial Regression ◽  
Cd4 Count ◽  
Generalized Poisson ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Binomial Regression ◽  
Cd4 Cell

Abstract Objective CD4 Lymphocyte Count (CD4) is a major predictor of HIV progression to AIDS. Exploring the factors affecting CD4 levels may assist healthcare staff and patients in management and monitoring of health cares. This retrospective cohort study aimed to explore factors associated with CD4 cell counts at the time of diagnosis in HIV patients using Poisson, Generalized Poisson, and Negative Binomial regression models. Results Out of 4402 HIV patients diagnosis in Iran from 1987 to 2016, 3030 (68.8%) were males, and the mean age was 34.8 ± 10.4 years. The results indicate that the Negative Binomial model outperformed the other models in terms of AIC, log-likelihood and RMSE criteria. In this model, factors include sex, age, clinical stage and Tuberculosis (TB) co-infection were significantly associated with CD4 count (P < 0.05). Conclusion Given the effect of age, sex, clinical stage and stage of HIV on CD4 count of the patients, adopting policies and strategies to increase awareness and encourage people to seek early HIV testing and care is advantageous.

scholarly journals Inter- and intra-laboratory variability of CD4 cell counts in Swaziland

2012 ◽  
Vol 13 (2) ◽  
Author(s):  
Ganizani Mlawanda ◽  
Paul Rheeder ◽  
Jacqui Miot
Keyword(s):  
Time Lapse ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
Sample Collection ◽  
Cross Sectional ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
The Mean ◽  
Cd4 Percentage ◽  
Cd4 Cell

Background. Analytical variability in CD4 enumeration is well known, but few studies from southern Africa have quantified the inter- and intra-laboratory variability in CD4 count measurements. In addition, the possible impact of time lapse after sample collection on CD4 reliability is not well understood. Methods. A cross-sectional study was conducted at Royal Swaziland Sugar Corporation Hospital and three laboratories, Lab A (comparator), Lab B (national reference) and Lab C (rural hospital). Blood from HIV-infected individuals was collected using routine venepuncture into separate specimens for each of the three laboratories. The samples were further subdivided at each laboratory: one was run at 12 hours and the second at 24 hours after venepuncture. The results of absolute CD4 count and CD4 percentage testing were compared within (intra-laboratory) and between (inter-laboratory) laboratories. Results. Among 53 participants, the mean CD4 count at 12 hours was 373 cells/μl, 396 cells/μl and 439 cells/μl, and at 24 hours 359 cells/μl, 389 cells/ μl and 431 cells/μl, for laboratories A, B and C, respectively. The coefficient of intra-laboratory variation was 4%, 8% and 20% for CD4 count for laboratories A, B and C, respectively. Comparing 12- and 24-hour measurements, the mean difference (bias) within the laboratories between the two time points (and limits of agreement, LOAs) was 14 (-46 to 73), 8 (-161 to 177) and 7 (20 to 33) cells/μl for labs A, B and C, respectively. Comparing Lab A versus Lab B, lab A versus Lab C and Lab B versus Lab C, the inter-laboratory bias for the CD4 count at 12 hours was -32, -64 and -38 cells/μl, respectively. The corresponding LOAs were -213 to 150, -183 to 55, and -300 to 224, respectively. At 24 hours, the biases and LOAs were similar to those at 12 hours. Conclusions. CD4 counts appeared reliable at all three laboratories. Lab B and Lab C were clinically interchangeable with the comparator laboratory, Lab A, but not between themselves. Time to measurement does not affect the interlaboratory agreement within 12 and 24 hours. S Afr J HIV Med 2012;13(2):59-63.

scholarly journals Frequency of Cytomegalovirus Viral Load in Iranian Human Immunodeficiency Virus-1-Infected Patients with CD4+ Counts <100 Cells/mm3

Intervirology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Mohammad Reza Jabbari ◽  
Hoorieh Soleimanjahi ◽  
Somayeh Shatizadeh Malekshahi ◽  
Mohammad Gholami ◽  
Leila Sadeghi ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Cell Count ◽  
Previous History ◽  
Cd4 Count ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Immunodeficiency Virus ◽  
Cd4 Cell ◽  
Hiv 1

<b><i>Objectives:</i></b> The aim of present work was to assess cytomegalovirus (CMV) viremia in Iranian human immunodeficiency virus (HIV)-1-infected patients with a CD4+ count &#x3c;100 cells/mm<sup>3</sup> and to explore whether CMV DNA loads correlate with CD4+ cell counts or associated retinitis. <b><i>Methods:</i></b> This study was conducted at the AIDS research center in Iran on HIV-1-infected patients with CD4+ count &#x3c;100 cells/mm<sup>3</sup>, antiretroviral therapy-naive, aged ≥18 years with no previous history of CMV end-organ disease (CMV-EOD). <b><i>Results:</i></b> Thirty-nine of 82 patients (47.56%) had detectable CMV viral load ranging from 66 to 485,500 IU/mL. CMV viral load in patients with retinitis ranges from 352 to 2,720 IU/mL, and it was undetectable in 2 patients. No significant associations between CMV viremia and CD4+ cell count was found (<i>p</i> value = 0.31), whereas significant association of CMV viremia in HIV-infected patients with retinitis was found (<i>p</i> &#x3c; 0.02). <b><i>Conclusions:</i></b> We estimated the frequency of CMV viral load infection in Iranian HIV-1-infected patients with a CD4+ cell count &#x3c;100 mm<sup>3</sup>/mL in the largest national referral center for HIV-1 infection in Iran. Further research is required on the relevance of CMV viral load in diagnostic and prognostic value of CMV-EOD.

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