Cargando…

Screening HIV-infected adults in Malawi for anaemia: impact on eligibility for antiretroviral therapy

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 patien...

Descripción completa

Detalles Bibliográficos
Autores principales: Page, I D, McKew, S J, Kudzala, A G, Fullwood, C, van Oosterhout, J J, Bates, I
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764951/
https://www.ncbi.nlm.nih.gov/pubmed/23970747
http://dx.doi.org/10.1177/0956462412472832
_version_ 1782283210664706048
author Page, I D
McKew, S J
Kudzala, A G
Fullwood, C
van Oosterhout, J J
Bates, I
author_facet Page, I D
McKew, S J
Kudzala, A G
Fullwood, C
van Oosterhout, J J
Bates, I
author_sort Page, I D
collection PubMed
description 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.
format Online
Article
Text
id pubmed-3764951
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-37649512013-09-09 Screening HIV-infected adults in Malawi for anaemia: impact on eligibility for antiretroviral therapy Page, I D McKew, S J Kudzala, A G Fullwood, C van Oosterhout, J J Bates, I Int J STD AIDS Original Research Articles 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. SAGE Publications 2013-06 /pmc/articles/PMC3764951/ /pubmed/23970747 http://dx.doi.org/10.1177/0956462412472832 Text en © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav http://creativecommons.org/licenses/by-nc/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research Articles
Page, I D
McKew, S J
Kudzala, A G
Fullwood, C
van Oosterhout, J J
Bates, I
Screening HIV-infected adults in Malawi for anaemia: impact on eligibility for antiretroviral therapy
title Screening HIV-infected adults in Malawi for anaemia: impact on eligibility for antiretroviral therapy
title_full Screening HIV-infected adults in Malawi for anaemia: impact on eligibility for antiretroviral therapy
title_fullStr Screening HIV-infected adults in Malawi for anaemia: impact on eligibility for antiretroviral therapy
title_full_unstemmed Screening HIV-infected adults in Malawi for anaemia: impact on eligibility for antiretroviral therapy
title_short Screening HIV-infected adults in Malawi for anaemia: impact on eligibility for antiretroviral therapy
title_sort screening hiv-infected adults in malawi for anaemia: impact on eligibility for antiretroviral therapy
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764951/
https://www.ncbi.nlm.nih.gov/pubmed/23970747
http://dx.doi.org/10.1177/0956462412472832
work_keys_str_mv AT pageid screeninghivinfectedadultsinmalawiforanaemiaimpactoneligibilityforantiretroviraltherapy
AT mckewsj screeninghivinfectedadultsinmalawiforanaemiaimpactoneligibilityforantiretroviraltherapy
AT kudzalaag screeninghivinfectedadultsinmalawiforanaemiaimpactoneligibilityforantiretroviraltherapy
AT fullwoodc screeninghivinfectedadultsinmalawiforanaemiaimpactoneligibilityforantiretroviraltherapy
AT vanoosterhoutjj screeninghivinfectedadultsinmalawiforanaemiaimpactoneligibilityforantiretroviraltherapy
AT batesi screeninghivinfectedadultsinmalawiforanaemiaimpactoneligibilityforantiretroviraltherapy