January 31, 2013
CD4 Tests Aren’t Needed More Than Once a Year If HIV Is Suppressed
When an HIV-positive person’s virus is suppressed, the event of CD4 cells dropping significantly is so unlikely that CD4 tests more than yearly are probably unnecessary, especially if the immune cells are already above 300, aidsmap reports. The United States Department of Veterans Affairs conducted a study of HIV-positive people taking antiretrovirals (ARVs) to ascertain the risk of their CD4 cells falling below 200—which would put them at risk for opportunistic infections—provided their viral load was suppressed below 200.
The study included 832 people receiving HIV care between 1998 and 2011, all of whom had CD4 and viral load tests taken in conjunction with one another, with a median of 113 days separating tests. Ninety-three percent of those studied kept their CD4 counts above 200 when they were virally suppressed. A total of 61 participants experienced CD4 counts below 200, although for 24 of them the cause of the drop was not related to the virus.
The researchers deduced that people who are virally suppressed and have CD4 counts between 300 and 349 have a 95 percent probability of maintaining CD4 counts above 200 over a four-year period. When CD4 counts were above 350 at the outset, the probability increased to 97 percent and to 99 percent when non-HIV-related causes of the drop in CD4 cells were factored out.
The study authors argued that reducing CD4 screens to once per year for virally suppressed patients would save both money and the anxiety patients often suffer from observing the fluctuations in CD4 counts that aren’t clinically relevant.
To read the aidsmap story, click here.
Search: HIV, CD4 test, viral load test, aidsmap, suppression, United States Department of Veterans Affairs, antiretrovirals, ARVs.
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comments 1 - 6 (of 6 total)
James H. Wilson, San Francisco, 2013-02-13 15:34:22
I would argue the point of this aticle, without the continued, granted not on a weekly or monthly basis, CD4 counts it becomes unknown information. The followed counts maybe give way to other problems that may pop up that may have been averted with the follow up of the counts.
" and the anxiety patients often suffer from observing the fluctuations in CD4 counts that aren’t clinically relevant." and if this info causes patients stress then the doctor should know this and not inform Patients.
bufguy, Buffalo, NY, 2013-02-06 17:33:55
The recommendation is to limit CD4 testing to 1 year, not viral load. What the study said is that if viral load remains low or peferably undetectable the chances of CD4 dropping below 200 is negligible. If viral load goes up then CD4 would be worth testing
June, houston, 2013-02-06 15:26:37
I agree. Once a year is good for me. Tired interupting my days just to hear the dowctor say everything is fine.
MASTERMAT, BOSTON, MA,USA, 2013-02-06 13:30:39
A blanket rule of waiting a yr between CD4 tests, seems like a long time. alot can happen in a yr. Should factor in illness, the viral load, and how the person is doing. would recomend that every six months, would be the average, with some people able to go a yr. You need to catch drops, before they impact the health. Think it is to soon to go to one yr between CD4 tests, for the average person with hiv....
Vince, Gainesville, FL, 2013-02-06 11:56:42
Really, trying to spare us the anxiety? REALLY? It's all about the dollar. My virus is the proverbial Italian sports car. It goes from zero to sixty in ten seconds flat. This is the same load they they try to sell to women over mamogram frequency, etc. and it's all about the money. And you know what? We are worth the expense.
Eric B., Ann Arbor, MI, 2013-02-04 10:45:33
comments 1 - 6 (of 6 total)
I'd like to think that the usefulness of a CD4 count performed at least every six months is useful in order to identify a downward trend before getting dangerously low.
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