Ford Nathan, Meintjes Graeme, Pozniak Anton L., Bygrave Helen, Hill Andrew, Peter Trevor, Davies Mary-Ann, Grinsztejn Beatriz, Calmy Alexandra, Kumarasamy N., Phanuphak Prahan, Debeaudrap Pierre, Vitoria Marco, Doherty Meg, Stevens Wendy Susan et Siberry George (2015) « The future role of CD4 cell count for monitoring antiretroviral therapy », Lancet Infect Dis, 15 (2) (février), p. 241-7. DOI : 10.1016/S1473-3099(14)70896-5.
Résumé : 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.
Mots-clés : *Antiretroviral Therapy, Highly Active, Anti-Retroviral Agents/*therapeutic use, CD4 Lymphocyte Count/*utilization, Drug Monitoring/*methods, HIV Infections/*drug therapy, Humans.
Note
<p>1474-4457 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 Stevens, Wendy Siberry, George K 001/World Health Organization/International Journal Article Review United States Lancet Infect Dis. 2015 Feb;15(2):241-7. doi: 10.1016/S1473-3099(14)70896-5. Epub 2014 Nov 19.</p>