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    Use of WHO clinical stage for assessing patient eligibility to antiretroviral therapy in a routine health service setting in Jinja, Uganda

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    The final, definitive version of this paper has been published in AIDS Research and Therapy Vol. 5 No. 4 (28 February 2008) published by Bio Med Central Ltd DOI: 10.1186/1742-6405-5-4 http://www.aidsrestherapy.com/content/5/1/4. All rights reserved. (157.9Kb)
    Date
    2008-02-28
    Author
    Jaffar, Shabbar
    Birungi, Josephine
    Grosskurth, Heiner
    Amuron, Barbara
    Namara, Geoffrey
    Nabiryo, Christine
    Coutinho, Alex
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    Abstract
    In a routine service delivery setting in Uganda, we assessed the ability of the WHO clinical stage to accurately identify HIV-infected patients in whom antiretroviral therapy should be started. Among 4302 subjects screened for ART, the sensitivity and specificity (95% CI) of WHO stage III, IV against a CD4 count < 200 × 106/l were 52% (50, 54%) and 68% (66, 70%) respectively. Plasma viral load was tested in a subset of 1453 subjects in whom ART was initiated. Among 938 subjects with plasma viral load of 100,000 copies or more, 391 (42%, 95% CI 39, 45%) were at WHO stage I or II. In this setting, a large number of individuals could have been denied access to antiretroviral therapy if eligibility to ART was assessed on the basis of WHO clinical stage. There is an urgent need for greater CD4 count testing and evaluation of the utility of plasma viral load prior to initiation of ART to accompany the roll-out of ART.
    Use this URI to cite this item:
    https://hdl.handle.net/20.500.11951/342
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