Switch from 200 to 350 CD4 baseline count: what it means to HIV care and treatment programs in Kenya.
BACKGROUND
With the increasing population of infected individuals in Africa and constrained resources for care and treatment, antiretroviral management continues to be an important public health challenge. Since the announcement of World Health Organization recommendation and guidelines for initiation of antiretroviral Treatment at CD4 count below 350, many developing countries are adopting this strategy in their country specific guidelines to care and treatment of HIV and AIDS. Despite the benefits to these recommendations, what does this switch from 200 to 350 CD4 count mean in antiretroviral treatment demand?


METHODS
A Multi-centre study involving 1376 patients in health care settings in Kenya. CD4 count was carried out by flow cytometry among the HIV infected individuals in Kenya and results analyzed in view of the In-country and the new CD4 recommendation for initiation of antiretroviral treatment.


RESULTS
Across sites, 32% of the individual required antiretroviral at <200 CD4 Baseline, 40% at <250 baseline count and 58% based on the new criteria of <350 CD4 Count. There were more female (68%) than Male (32%).Different from <200 and <250 CD4 baseline criteria, over 50% of all age groups required antiretroviral at 350 CD4 baseline. Age groups between 41-62 led in demand for ART.


CONCLUSIONS
With the new guidelines, demand for ARVs has more than doubled with variations noted within regions and age groups. As A result, HIV Care and Treatment Programs should prepare for this expansion for the benefits to be realized.
Centre for Virus Research, Kenya Medical research Institute, Nairobi, Kenya.
Joseph
J
Mwangi
Zipporah
Z
Nganga
Raphael
R
Lihana
Nancy
N
Lagat
Joyceline
J
Kinyua
Joseph
J
Muriuki
Alex
A
Maiyo
Florence
F
Kinyua
Fredrick
F
Okoth
Solomon
S
Mpoke
D000328:Adult; D017677:Age Distribution; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count / Q000379:methods*; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D017678:Sex Distribution; D014944:World Health Organization; D055815:Young Adult
D019380:Anti-HIV Agents