Central Hospital, Yaoundé, Cameroon.
Trop Med Int Health. 2010 May;15(5):580-3. doi: 10.1111/j.1365-3156.2010.02495.x. Epub 2010 Mar 1.
To assess the proportion of patients infected with HIV with a CD4 count above 350 cells/mm(3) among those classified at WHO clinical stage 3 or 4 who initiated antiretroviral therapy in rural district hospitals in Cameroon to assess the 2009 revised WHO recommendations.
Cross-sectional study in nine rural district hospitals where the treatment initiation is based on the WHO clinical criteria. The proportion of patients who were classified at stage 3 or 4 and who had a CD4 count >350 cells/mm(3) was assessed.
Of 458 patients included in 2006-2008 (women 70.5%; median age 37.0 years), 337 (73.6%) were classified at WHO clinical stage 3 and 121 (26.4%) at stage 4. Overall, 108 patients (23.6%) had a CD4 count >350 cells/mm(3). Of them, 94 patients (20.5%) were classified at WHO clinical stage 3, and 14 (3.1%) were classified at WHO clinical stage 4.
The WHO clinical stages 3 and 4 were poorly correlated with the 'gold standard' of CD4 cell count. This study highlights the need to promote CD4 testing for assessing the patient eligibility.
评估在喀麦隆农村地区医院开始接受抗逆转录病毒治疗的、被归类为世界卫生组织（WHO）临床 3 或 4 期的 HIV 感染患者中，CD4 计数高于 350 个细胞/mm³的患者比例，以评估 2009 年修订的 WHO 建议。
这是一项在 9 家农村地区医院进行的横断面研究，这些医院的治疗起始依据是 WHO 的临床标准。评估了被归类为 3 或 4 期且 CD4 计数>350 个细胞/mm³的患者比例。
在 2006 年至 2008 年期间纳入的 458 例患者中（女性占 70.5%；中位年龄为 37.0 岁），337 例（73.6%）被归类为 WHO 临床 3 期，121 例（26.4%）被归类为 4 期。总体而言，有 108 例（23.6%）患者的 CD4 计数>350 个细胞/mm³。其中，94 例（20.5%）被归类为 WHO 临床 3 期，14 例（3.1%）被归类为 WHO 临床 4 期。
WHO 临床分期 3 期和 4 期与 CD4 细胞计数的“金标准”相关性较差。本研究强调需要推广 CD4 检测，以评估患者的资格。
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