Screening HIV-infected Adults in Malawi for Anaemia: Impact on Eligibility for Antiretroviral Therapy

Overview

Journal Int J STD AIDS

Specialty Infectious Diseases

Date 2013 Aug 24

PMID 23970747

Citations 2

Authors

I D Page

S J McKew

A G Kudzala

C Fullwood

J J van Oosterhout

I Bates

Affiliations

Soon will be listed here.

Abstract

Clinical staging determines antiretroviral therapy (ART) eligibility when CD4 count is not available. Haemoglobin (Hb) ≤8 g/dL is an indication for the treatment. We measured Hb in HIV-positive Malawian adults undergoing clinical assessment for ART eligibility and calculated the percentage of patients with CD4 ≤ 350 cells/μL deemed eligible for ART by clinical staging with and without Hb measurement, using the existing threshold and an alternative proposed after comparing Hb values to CD4 counts. Three hundred and thirty-eight patients had CD4 counts measured and 226 (67%) had CD4 ≤ 350 cells/μL. Thirty-six (16%) patients with low CD4 count were eligible for ART by clinical assessment alone, 48 (21%) when Hb was also measured with a threshold of ≤8 g/dL and 74 (34%) with a threshold of ≤10 g/dL. Measuring Hb alongside clinical assessment could increase the number of patients with CD4 ≤ 350 cells/μL starting ART by 33% using a threshold of Hb ≤ 8 g/dL or 114% with a threshold of ≤10g/dL.

Citing Articles

Practical Management of HIV-Associated Anemia in Resource-Limited Settings: Prospective Observational Evaluation of a New Mozambican Guideline.

Brentlinger P, Silva W, Vermund S, Valverde E, Buene M, Moon T AIDS Res Hum Retroviruses. 2015; 32(1):12-25.

PMID: 26178574 PMC: 4692124. DOI: 10.1089/AID.2015.0030.

Diagnostic accuracy of the WHO clinical staging system for defining eligibility for ART in sub-Saharan Africa: a systematic review and meta-analysis.

Munthali C, Taegtmeyer M, Garner P, Lalloo D, Squire S, Corbett E J Int AIDS Soc. 2014; 17:18932.

PMID: 24929097 PMC: 4057784. DOI: 10.7448/IAS.17.1.18932.

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