Modelling the impact of CD4 testing on mortality from TB and cryptococcal meningitis among patients with advanced HIV disease in nine countries.
CD4 testing
TB mortality
advanced HIV disease
cryptococcal meningitis
deaths averted
mortality
Journal
Journal of the International AIDS Society
ISSN: 1758-2652
Titre abrégé: J Int AIDS Soc
Pays: Switzerland
ID NLM: 101478566
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
received:
07
07
2022
accepted:
10
02
2023
entrez:
7
3
2023
pubmed:
8
3
2023
medline:
9
3
2023
Statut:
ppublish
Résumé
Despite antiretroviral therapy (ART) scale-up among people living with HIV (PLHIV), those with advanced HIV disease (AHD) (defined in adults as CD4 count <200 cells/mm We used official estimates and existing epidemiological data to project deaths from tuberculosis (TB) and cryptococcal meningitis (CM) among PLHIV-initiating ART with CD4 <200 cells/mm The effect of CD4 testing comes through increased identification of AHD and consequent eligibility for protocols for AHD prevention, diagnosis and management; algorithms for CD4 testing avert between 31% and 38% of deaths from TB and CM in the first year of ART. The number of CD4 tests required per death averted varies widely by country from approximately 101 for South Africa to 917 for Kenya. This analysis supports retaining baseline CD4 testing to avert deaths from TB and CM, the two most deadly opportunistic infections among patients with AHD. However, national programmes will need to weigh the cost of increasing CD4 access against other HIV-related priorities and allocate resources accordingly.
Identifiants
pubmed: 36880429
doi: 10.1002/jia2.26070
pmc: PMC9989935
doi:
Substances chimiques
CD4 Antigens
0
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e26070Subventions
Organisme : NIAID NIH HHS
ID : P30 AI168386
Pays : United States
Organisme : CGH CDC HHS
ID : U2G GH000994
Pays : United States
Organisme : PEPFAR
Pays : United States
Informations de copyright
© 2023 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.
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