CD4 cell count criteria to determine when to initiate antiretroviral therapy in human immunodeficiency virus-infected children
Wongsawat, J.; Puthanakit, T.; Kanjanavanit, S.; Hansudewechakul, R.; Ngampiyaskul, C.; Kerr, S.J.; Ubolyam, S.; Suwanlerk, T.; Kosalaraksa, P.; Luesomboon, W.; Ngo-Giang-Huong, N.; Chandara, M.; Saphonn, V.; Ruxrungtham, K.; Ananworanich, J.
Pediatric Infectious Disease Journal 29(10): 966-968
2010
ISSN/ISBN: 1532-0987 PMID: 20418798 DOI: 10.1097/inf.0b013e3181e0554cDocument Number: 625646
We evaluated the validity of CD4 count against CD4% criteria of 2008 World Health Organization guideline for initiating antiretroviral therapy using the data of 446 human immunodeficiency virus-infected Asian children aged 1 to 12 years who were screened to the Pediatric Randomized of Early versus Deferred Initiation in Cambodia and Thailand study. The overall sensitivity and specificity were 34% and 98%, respectively. Using the current CD4 count criteria would globally result in 66% missed opportunity to initiate treatment in a timely fashion. Raising CD4 count thresholds should be considered to increase its sensitivity and reduce missed opportunity.