TUESDAY, Aug. 29 (HealthDay News) -- After HIV-positive patients start highly active antiretroviral therapy, an increased CD4 cell count is only a moderate predictor of undetectable viral load and its predictive power is even more limited in patients with lower baseline CD4 cell counts, according to a study published in the August issue of AIDS.
Gregory Bisson, M.D., of the University of Pennsylvania School of Medicine in Philadelphia, and colleagues studied 384 patients at two HIV clinics in Botswana and measured their viral loads six months after the initiation of treatment.
In patients with baseline CD4 cell counts of less than 100 cells/μL, the researchers found that the sensitivity, specificity, and positive and negative predictive values of a CD4 cell count increase of at least 50 cells/μL for an undetectable viral load were 93.1, 61.3, 92.5 and 63.3 percent, respectively. They also found that the comparable values of a CD4 cell count increase of more than 150 cells/μL were 47.8, 87.1, 95 and 24.5 percent, respectively.
"Although HIV treatment programs in resource-constrained settings could consider the use of CD4 cell count increases to triage viral load testing, more accurate approaches to monitoring virologic failure are urgently needed," the authors conclude.
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