CD4 cell count criteria to determine when to initiate antiretroviral therapy in human immunodeficiency virus-infected children
Jurai Wongsawat, Thanyawee Puthanakit, Suparat Kanjanavanit, Rawiwan Hansudewechakul, Chaiwat Ngampiyaskul, Stephen J Kerr, Sasiwimol Ubolyam, Tulathip Suwanlerk, Pope Kosalaraksa, Wicharn Luesomboon, Nicole Ngo-Giang-Huong, Mom Chandara, Vonthanak Saphonn, Kiat Ruxrungtham, Jintanat Ananworanich, PREDICT Study Group, Jurai Wongsawat, Thanyawee Puthanakit, Suparat Kanjanavanit, Rawiwan Hansudewechakul, Chaiwat Ngampiyaskul, Stephen J Kerr, Sasiwimol Ubolyam, Tulathip Suwanlerk, Pope Kosalaraksa, Wicharn Luesomboon, Nicole Ngo-Giang-Huong, Mom Chandara, Vonthanak Saphonn, Kiat Ruxrungtham, Jintanat Ananworanich, PREDICT Study Group
Abstract
We evaluated the validity of CD4 count against CD4% criteria of 2008 World Health Organization guideline for initiating antiretroviral therapy using the data of 446 human immunodeficiency virus-infected Asian children aged 1 to 12 years who were screened to the Pediatric Randomized of Early versus Deferred Initiation in Cambodia and Thailand study. The overall sensitivity and specificity were 34% and 98%, respectively. Using the current CD4 count criteria would globally result in 66% missed opportunity to initiate treatment in a timely fashion. Raising CD4 count thresholds should be considered to increase its sensitivity and reduce missed opportunity.
Trial registration: ClinicalTrials.gov NCT00234091.
Source: PubMed