乌干达实施“治疗即预防”后，CD4 计数检测次数减少。
Reduction in Baseline CD4 Count Testing Following Human Immunodeficiency Virus "Treat All" Adoption in Uganda.
机构信息
Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
出版信息
Clin Infect Dis. 2020 Dec 3;71(9):2497-2499. doi: 10.1093/cid/ciaa261.
Abstract
Baseline CD4 testing rates declined from 73% to 21% between 2013 and 2018 with adoption of "Treat All" in Uganda. Advanced human immunodeficiency virus (HIV) disease (CD4 count < 200 cells/µL) remained common (24% of those tested in 2018, 83% of whom had World Health Organization stage I/II disease). Despite frequent presentation with advanced HIV disease, CD4 testing has declined dramatically.
摘要
在乌干达采用“治疗所有”策略后，2013 年至 2018 年期间，基础 CD4 检测率从 73%下降至 21%。晚期人类免疫缺陷病毒（HIV）疾病（CD4 计数 < 200 个/µL）仍然很常见（2018 年接受检测的人群中有 24%，其中 83%患有世界卫生组织 I/II 期疾病）。尽管经常出现晚期 HIV 疾病，但 CD4 检测却大幅下降。
相似文献
1
Reduction in Baseline CD4 Count Testing Following Human Immunodeficiency Virus "Treat All" Adoption in Uganda.
Clin Infect Dis. 2020 Dec 3;71(9):2497-2499. doi: 10.1093/cid/ciaa261.
2
CD4 T-lymphocyte recovery in individuals with advanced HIV-1 infection receiving potent antiretroviral therapy for 4 years: the Swiss HIV Cohort Study.
Arch Intern Med. 2003 Oct 13;163(18):2187-95. doi: 10.1001/archinte.163.18.2187.
3
Uptake of antiretroviral therapy and male circumcision after community-based HIV testing and strategies for linkage to care versus standard clinic referral: a multisite, open-label, randomised controlled trial in South Africa and Uganda.
Lancet HIV. 2016 May;3(5):e212-20. doi: 10.1016/S2352-3018(16)00020-5. Epub 2016 Mar 10.
4
Rates of disease progression by baseline CD4 cell count and viral load after initiating triple-drug therapy.
JAMA. 2001 Nov 28;286(20):2568-77. doi: 10.1001/jama.286.20.2568.
5
CD4+ cell count 6 years after commencement of highly active antiretroviral therapy in persons with sustained virologic suppression.
Clin Infect Dis. 2007 Feb 1;44(3):441-6. doi: 10.1086/510746. Epub 2006 Dec 20.
6
Evaluation of the effectiveness of highly active antiretroviral therapy in persons with human immunodeficiency virus using biomarker-based equivalence of disease progression.
Am J Epidemiol. 2002 Apr 15;155(8):760-70. doi: 10.1093/aje/155.8.760.
7
Long-term experience providing antiretroviral drugs in a fee-for-service HIV clinic in Uganda: evidence of extended virologic and CD4+ cell count responses.
J Acquir Immune Defic Syndr. 2005 Apr 15;38(5):578-83. doi: 10.1097/01.qai.0000134742.26338.2f.
8
CD4 cell count recovery among HIV-infected patients with very advanced immunodeficiency commencing antiretroviral treatment in sub-Saharan Africa.
BMC Infect Dis. 2006 Mar 21;6:59. doi: 10.1186/1471-2334-6-59.
9
Late presentation for human immunodeficiency virus HIV diagnosis results of a Belgian single centre.
Acta Clin Belg. 2014 Jan-Feb;69(1):33-9. doi: 10.1179/0001551213Z.00000000014.
10
When to begin highly active antiretroviral therapy? Evidence supporting initiation of therapy at CD4+ lymphocyte counts <350 cells/microL.
Clin Infect Dis. 2003 Oct 1;37(7):951-8. doi: 10.1086/377606. Epub 2003 Sep 12.
引用本文的文献
1
Incidence and risk factors for tuberculosis at a rural HIV clinic in Uganda, 2012-2019; A retrospective cohort study.
BMC Public Health. 2025 May 22;25(1):1882. doi: 10.1186/s12889-025-23090-8.
2
A Prospective Evaluation of the Diagnostic Accuracy of the Point-of-Care VISITECT CD4 Advanced Disease Test in 7 Countries.
J Infect Dis. 2025 Feb 4;231(1):e82-e90. doi: 10.1093/infdis/jiae374.
3
The effect of the Universal Test and Treat policy uptake on CD4 count testing and incidence of opportunistic infections among people living with HIV infection in Cameroon: a retrospective analysis of routine data.
Dialogues Health. 2023 Feb 26;2:100120. doi: 10.1016/j.dialog.2023.100120. eCollection 2023 Dec.
4
Sensitivity and specificity of CRP and symptom screening as tuberculosis screening tools among HIV-positive and negative outpatients at a primary healthcare facility in Lusaka, Zambia: a prospective cross-sectional study.
BMJ Open. 2023 Apr 18;13(4):e061907. doi: 10.1136/bmjopen-2022-061907.
5
Advanced HIV disease and associated attrition after re-engagement in HIV care in Myanmar from 2003 to 2019: a retrospective cohort study.
Int Health. 2023 Jul 4;15(4):453-461. doi: 10.1093/inthealth/ihac069.
6
Cost-effectiveness of single-dose AmBisome pre-emptive treatment for the prevention of cryptococcal meningitis in African low and middle-income countries.
Med Mycol. 2022 Feb 1;60(2). doi: 10.1093/mmy/myab078.
7
Effects of implementing universal and rapid HIV treatment on initiation of antiretroviral therapy and retention in care in Zambia: a natural experiment using regression discontinuity.
Lancet HIV. 2021 Dec;8(12):e755-e765. doi: 10.1016/S2352-3018(21)00186-7. Epub 2021 Oct 14.
8
Utility of CD4 count measurement in the era of universal antiretroviral therapy: an analysis of routine laboratory data in Botswana.
HIV Med. 2021 Jan;22(1):1-10. doi: 10.1111/hiv.12951. Epub 2020 Sep 2.
9
The Enduring Burden of Advanced Human Immunodeficiency Virus Disease.
Clin Infect Dis. 2020 Dec 3;71(9):2500-2501. doi: 10.1093/cid/ciaa265.
本文引用的文献
1
Rapid urine-based screening for tuberculosis in HIV-positive patients admitted to hospital in Africa (STAMP): a pragmatic, multicentre, parallel-group, double-blind, randomised controlled trial.
Lancet. 2018 Jul 28;392(10144):292-301. doi: 10.1016/S0140-6736(18)31267-4. Epub 2018 Jul 20.
2
Persistent High Burden of Advanced HIV Disease Among Patients Seeking Care in South Africa's National HIV Program: Data From a Nationwide Laboratory Cohort.
Clin Infect Dis. 2018 Mar 4;66(suppl_2):S111-S117. doi: 10.1093/cid/ciy045.
3
Advanced Human Immunodeficiency Virus Disease at Diagnosis in Mozambique and Swaziland.
Open Forum Infect Dis. 2017 Jul 23;4(3):ofx156. doi: 10.1093/ofid/ofx156. eCollection 2017 Summer.
4
Enhanced Prophylaxis plus Antiretroviral Therapy for Advanced HIV Infection in Africa.
N Engl J Med. 2017 Jul 20;377(3):233-245. doi: 10.1056/NEJMoa1615822.
5
Effect on mortality of point-of-care, urine-based lipoarabinomannan testing to guide tuberculosis treatment initiation in HIV-positive hospital inpatients: a pragmatic, parallel-group, multicountry, open-label, randomised controlled trial.
Lancet. 2016 Mar 19;387(10024):1187-97. doi: 10.1016/S0140-6736(15)01092-2. Epub 2016 Mar 10.
6
Cryptococcal meningitis screening and community-based early adherence support in people with advanced HIV infection starting antiretroviral therapy in Tanzania and Zambia: an open-label, randomised controlled trial.
Lancet. 2015 May 30;385(9983):2173-82. doi: 10.1016/S0140-6736(15)60164-7. Epub 2015 Mar 10.
7
Diagnostic accuracy of the WHO clinical staging system for defining eligibility for ART in sub-Saharan Africa: a systematic review and meta-analysis.
J Int AIDS Soc. 2014 Jun 12;17(1):18932. doi: 10.7448/IAS.17.1.18932. eCollection 2014.
8
Reduction in early mortality on antiretroviral therapy for adults in rural South Africa since change in CD4+ cell count eligibility criteria.
J Acquir Immune Defic Syndr. 2014 Jan 1;65(1):e17-24. doi: 10.1097/QAI.0b013e31829ceb14.
9
Daily co-trimoxazole prophylaxis in severely immunosuppressed HIV-infected adults in Africa started on combination antiretroviral therapy: an observational analysis of the DART cohort.
Lancet. 2010 Apr 10;375(9722):1278-86. doi: 10.1016/S0140-6736(10)60057-8. Epub 2010 Mar 27.
Zotero 插件