RETRACTED: Validity of existing CD4+ classification in north Indians, in predicting immune status

Attili, Venkata Satya Suresh; Sundar, Shyam; Singh, Vakil; Rai, Madhukar

doi:10.1016/j.jinf.2004.08.022

Cited by 8 publications

(5 citation statements)

References 20 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CD4 counts in non‐smoking women in this Senegalese population were somewhat lower than those reported recently in healthy adults in more developed nations such as Italy and the United States, but are higher than those reported in countries such as India, Botswana and Singapore (Fig. 1) [27–43]. Similarly, CD4 counts in Senegalese men in the current study, who all presented to an out‐patient ID clinic with symptoms of infectious diseases, were generally lower than those observed in other populations, although Senegalese men who smoked had high CD4 counts compared to most populations.…”

Section: Discussioncontrasting

confidence: 65%

Factors associated with CD4 lymphocyte counts in HIV-negative Senegalese individuals

Mair¹,

Hawes²,

Agne

et al. 2008

Clinical and Experimental Immunology

View full text Add to dashboard Cite

Summary CD4+ lymphocytes are a primary target of the human immunodeficiency virus (HIV), and CD4 counts are one of the factors used to measure disease progression in HIV-positive individuals. CD4 counts vary in uninfected individuals and across populations due to a variety of demographic, environmental, immunological and genetic factors that probably persist throughout the course of HIV infection. This study sought to determine reference levels and identify factors that influence lymphocyte counts in 681 HIV-uninfected adults in Senegal, where residents are exposed to a variety of infectious diseases and other conditions that may affect CD4 counts. Lymphocyte counts were assessed in commercial sex workers, symptomatic men and women presenting to the University of Dakar infectious disease clinic for out-patient care and women seeking family planning services. CD4 and CD3 lymphocyte counts differed between the four study groups (P < 0·01). Men had the lowest mean CD4 count (711·6 cells/ml), while commercial sex workers had the highest levels (966·0 cells/ml). After adjustment for age and other behavioural and clinical factors, the difference in CD4 counts between the three groups of women did not remain. However, both gender and smoking were associated independently with CD4 counts, as men maintained lower mean CD4 counts (b = -156·4 cells/ml, P < 0·01) and smokers had higher mean CD4 counts (b = 124·0 cells/ml, P < 0·01) than non-smokers in multivariable analyses. This study is the first to explore factors that may influence CD4 levels in Senegal and to estimate baseline CD4 levels among HIV-negatives, information that may guide clinicians in interpreting CD4 counts.

show abstract

Section: Discussioncontrasting

confidence: 65%

Factors associated with CD4 lymphocyte counts in HIV-negative Senegalese individuals

Mair¹,

Hawes²,

Agne

et al. 2008

Clinical and Experimental Immunology

View full text Add to dashboard Cite

show abstract

“…Similar findings have also been reported by other Indian authors, such as Attili et al from North India (>280, 120-280, and 120 cells/mm 3 ) 7 and Ramalingam et al from South India (>300, 81-300, and 81 cells/mm 3 ) 8 and from authors in Asia and Africa. 9,10 There have also been reports of lower CD4 counts in the Indian population 7,8,[11][12][13] and HIV-uninfected ethnic groups. 9,10 Also, India has a high burden of people living with HIV/AIDS (PLHA).…”

Section: Discussionsupporting

confidence: 90%

CD4 Counts in Laboratory Monitoring of HIV Disease—Experience from Western India

Ingole

Nataraj

Mehta

et al. 2013

J Int Assoc Provid AIDS Care

View full text Add to dashboard Cite

Background: CD4 counts vary in different populations. The present study was conducted to determine CD4 counts in different World Health Organization (WHO) clinical stages in antiretroviral therapy naïve individuals and to find out optimum CD4 cutoffs.Method: Data of adult HIV seropositive patients who underwent CD4 count and total lymphocyte count (TLC) testing were included for analysis. The severity of immunosuppression was graded based on WHO criteria. To establish optimum CD4 cutoff values, receiver-operator characteristics (ROC) curves were generated. Results: Of 754 patients, 52.2% had CD4 counts <200 cells/mm 3 , but only 2.3% belonged to WHO stage IV. Newer CD4 cutoffs generated were 280, 120-280, <120 cells/mm 3 . Spearman rank correlation between CD4 counts and TLC was found to be weak (r = .32). Conclusion: The cutoff values of CD4 counts for HIV disease may need to be revised for India. Regular CD4 count estimation is a must for monitoring disease progression in people living with HIV/AIDS.

show abstract

“…The World Health Organisation (WHO) has recommended using CD4 + cell counts to decide when treatment should be initiated [5], but in many settings the decision to start therapy is made without any laboratory support, and instead makes use of disease staging criteria [10]. Although early signs of disease can be apparent within a few years of HIV infection [11,12], advanced immune depletion and the need for ART are not always associated with symptoms [13–15]. …”

Section: Introductionmentioning

confidence: 99%

The Impact of Monitoring HIV Patients Prior to Treatment in Resource-Poor Settings: Insights from Mathematical Modelling

et al. 2008

View full text Add to dashboard Cite

BackgroundThe roll-out of antiretroviral treatment (ART) in developing countries concentrates on finding patients currently in need, but over time many HIV-infected individuals will be identified who will require treatment in the future. We investigated the potential influence of alternative patient management and ART initiation strategies on the impact of ART programmes in sub-Saharan Africa.Methods and FindingsWe developed a stochastic mathematical model representing disease progression, diagnosis, clinical monitoring, and survival in a cohort of 1,000 hypothetical HIV-infected individuals in Africa. If individuals primarily enter ART programmes when symptomatic, the model predicts that only 25% will start treatment and, on average, 6 life-years will be saved per person treated. If individuals are recruited to programmes while still healthy and are frequently monitored, and CD4+ cell counts are used to help decide when to initiate ART, three times as many are expected to be treated, and average life-years saved among those treated increases to 15. The impact of programmes can be improved further by performing a second CD4+ cell count when the initial value is close to the threshold for starting treatment, maintaining high patient follow-up rates, and prioritising monitoring the oldest (≥ 35 y) and most immune-suppressed patients (CD4+ cell count ≤ 350). Initiating ART at higher CD4+ cell counts than WHO recommends leads to more life-years saved, but disproportionately more years spent on ART.ConclusionsThe overall impact of ART programmes will be limited if rates of diagnosis are low and individuals enter care too late. Frequently monitoring individuals at all stages of HIV infection and using CD4 cell count information to determine when to start treatment can maximise the impact of ART.

show abstract

RETRACTED: Validity of existing CD4+ classification in north Indians, in predicting immune status

Cited by 8 publications

References 20 publications

Factors associated with CD4 lymphocyte counts in HIV-negative Senegalese individuals

Factors associated with CD4 lymphocyte counts in HIV-negative Senegalese individuals

CD4 Counts in Laboratory Monitoring of HIV Disease—Experience from Western India

The Impact of Monitoring HIV Patients Prior to Treatment in Resource-Poor Settings: Insights from Mathematical Modelling

Contact Info

Product

Resources

About