title: CD4 counts and viral loads of newly diagnosed HIV-infected individuals: implications for treatment as prevention.
abstract: OBJECTIVE
  To report the viral load and CD4 count in HIV-infected, antiretroviral naïve, first -time HIV-testers, not immediately eligible for treatment initiation by current South Africa treatment guidelines.
  
  
  METHODS
  This was a cross-sectional study in a high-volume, free-of-charge HIV testing centre in Soweto, South Africa.
  
  
  METHODS
  We enrolled first time HIV testers and collected demographic and risk-behaviour data and measured CD4 count and viral load.
  
  
  RESULTS
  Between March and October 2011, a total of 4793 adults attended VCT and 1062 (22%) tested positive. Of the 1062, 799 (75%) were ART naïve and 348/799 (44%) were first-time HIV testers. Of this group of 348, 225 (65%) were female. Overall their median age, CD4 count and viral load was 34 years (IQR: 28-41), 364 (IQR: 238-542) cells/mm3 and 13,000 (IQR: 2050-98171) copies/ml, respectively. Female first time HIV testers had higher CD4 counts (419 IQR: 262-582 vs. 303 IQR: 199-418 cells/mm3) and lower viral loads (9,100 vs. 34,000 copies/ml) compared to males. Of 183 participants with CD4 count >350 cells/mm3, 62 (34%) had viral loads > 10,000 copies/ml.
  
  
  CONCLUSIONS
  A large proportion of HIV infected adults not qualifying for immediate ART at the CD4 count threshold of 350 cells/mm3 have high viral loads. HIV-infected men at their first HIV diagnosis are more likely to have lower CD4 counts and higher viral loads than women.
authors.affiliation: Perinatal HIV Research Unit (PHRU), University of the Witwatersrand and Baragwanath Hospital, Soweto, South Africa; Canada-Africa Prevention Trials Network, The Ottawa Hospital General Campus, Ottawa, Canada.
authors.forename: Sarishen
authors.initials: S
authors.lastname: Govender
authors.affiliation: Perinatal HIV Research Unit (PHRU), University of the Witwatersrand and Baragwanath Hospital, Soweto, South Africa.
authors.forename: Kennedy
authors.initials: K
authors.lastname: Otwombe
authors.affiliation: Perinatal HIV Research Unit (PHRU), University of the Witwatersrand and Baragwanath Hospital, Soweto, South Africa.
authors.forename: Thandekile
authors.initials: T
authors.lastname: Essien
authors.affiliation: Perinatal HIV Research Unit (PHRU), University of the Witwatersrand and Baragwanath Hospital, Soweto, South Africa.
authors.forename: Ravindre
authors.initials: R
authors.lastname: Panchia
authors.affiliation: Perinatal HIV Research Unit (PHRU), University of the Witwatersrand and Baragwanath Hospital, Soweto, South Africa.
authors.forename: Guy
authors.initials: G
authors.lastname: de Bruyn
authors.affiliation: Perinatal HIV Research Unit (PHRU), University of the Witwatersrand and Baragwanath Hospital, Soweto, South Africa.
authors.forename: Lerato
authors.initials: L
authors.lastname: Mohapi
authors.affiliation: Perinatal HIV Research Unit (PHRU), University of the Witwatersrand and Baragwanath Hospital, Soweto, South Africa.
authors.forename: Glenda
authors.initials: G
authors.lastname: Gray
authors.affiliation: Perinatal HIV Research Unit (PHRU), University of the Witwatersrand and Baragwanath Hospital, Soweto, South Africa; Johns Hopkins University, Center for TB Research, Baltimore, Maryland, United States of America.
authors.forename: Neil
authors.initials: N
authors.lastname: Martinson
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D013019:South Africa / Q000453:epidemiology; D019562:Viral Load