CD4 testing — still the best measurement to identify advanced HIV disease

Click the image above to read the full visual story about using CD4 cell count testing in efforts to reduce AIDS-related deaths

The COVID-19 pandemic has disrupted the provision of health care around the globe — and, for people living with HIV, has created additional barriers to seeking appropriate care, including the management and prevention of advanced HIV disease, or AHD. A Devex survey of more than 700 health professionals in 90 countries revealed that 90% expect AHD numbers to surge alongside COVID-19, with 42% citing limited access to health care facilities, commodities, and services as major factors.

The survey, conducted between Nov. 16 and Dec. 11, identified some of the challenges and opportunities around AHD — defined as a CD4 cell count below 200 per cubic millimeter of blood or a World Health Organization clinical stage 3 or 4 event — and the use of CD4 cell count testing as part of the efforts to reduce AIDS-related deaths.

In its latest guidelines for managing AHD, WHO notes, “CD4 cell count testing at baseline for all people living with HIV remains important,” adding that “Relying on clinical staging alone risks missing substantial numbers of people living with HIV with severe immune suppression.” While health care professionals agreed that CD4 cell count testing — recommended in the WHO “package of care” — is necessary, many said it was insufficiently implemented.

Only 55% of respondents said health care practitioners in their countries typically recommend CD4 testing to people newly diagnosed with HIV. Other gaps cited include limited CD4 testing equipment, limited public access to CD4 testing, and a lack of domestic funding as the top barriers to implementation.

Explore more survey takeaways on advanced HIV disease in this visual story.

Click the image above to read the full visual story about using CD4 cell count testing in efforts to reduce AIDS-related deaths

Visit the series for more coverage on how to make diagnostic tests and treatment for advanced HIV patients more accessible by sharing insights from practitioners, policymakers, and people living with AHD. You can join the conversation using the hashtag #AdvancedHIV.

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