[e-drug] New article on ARV Delivery in South Africa (cont'd)

[Chris.W.Green@healthnet.org (chrisg@rad.net.id)]

E-drug: New article on ARV Delivery in South Africa (cont'd)
---------------------------------------------

Suzanne Crowe notes the benefit of CD4 testing in allowing identification
of people with low CD4 counts but no significant symptoms.

Can these people also be identified by total lymphocyte count (TLC)? WHO
guidelines recommend starting therapy or prophylaxis if TLC drops below
1200. Is this sufficiently sensitive? Several algorithms have been
proposed to try to improve correlation between TLC and CD4 but it's not
clear if these have been widely validated. Does anyone have any experience
with them?

Chris
----------------------------------
Chris W. Green (chrisg@rad.net.id)
Jakarta, Indonesia
Tel: +62-21 846-3029  Fax: +62-21 846-1247
Chris W. Green (chrisg@rad.net.id)

[Suzanne Crowe is out of the country so not available at the moment 
for follow-up. Two responses from other specialist HIV physicians as 
follows:
Dr Anne Mijch, Alfred Hospital, Melbourne  - Yes TLC is OK for OI 
prophylaxis but not as sensitive if treating populations with ARVs.
Dr Tim Read, Melbourne Sexual Health Centre - I'm not sure how well 
total and CD4 lymphocyte counts correlate in studies, but in my 
experience they don't.  BS]

Access Essential Drugs Monitor #32 at http://www.who.int/medicines/mon/mon32.shtml

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