Predictors of CD4 eligibility for antiretroviral therapy initiation among HIV-infected pregnant women in Lusaka, Zambia
Liu, K.C.; Mulindwa, J.; Giganti, M.J.; Putta, N.B.; Chintu, N.; Chi, B.H.; Stringer, J.S.A.; Stringer, E.M.
Journal of Acquired Immune Deficiency Syndromes 57(5): E101-E105
2011
ISSN/ISBN: 1944-7884 PMID: 21499112 DOI: 10.1097/qai.0b013e31821d3507Document Number: 224891
In resource-limited settings, CD4 testing is a barrier to antiretroviral therapy initiation in pregnancy. We used logistic regression to identify predictors of CD4 cell count ≤ 350 cells/uL in 20,233 pregnant women. The best-performing model included any 3 of: age ≥ 28 years old, hemoglobin ≤ 9.8 g/dL, gestational age ≤ 30 weeks, weight ≤ 64 kg, history of tuberculosis or previous death of an infant prior to one year old. Sensitivity was 45.7% (95% CI: 44.5-47.0), specificity 70.7% (95% CI: 69.6-71.8), and misclassification rate 41.4% (95% CI: 40.5-42.2). CD4 triage remains a critical element of maternal HIV care and PMTCT.