ArticlePloS one2013
Population-based CD4 counts in a rural area in South Africa with high HIV prevalence and high antiretroviral treatment coverage.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed, 44 citations in OpenAlex.
- Assessing rates and contextual predictors of 5-year mortality among HIV-infected and HIV-uninfected individuals following HIV testing in Durban, South Africa.BMC infectious diseases · 2019Trial
- Optimizing pneumococcal prevention in South African older adults: Cost-effectiveness of PCV20 versus PPSV23 in the context of HIV-associated risk.Human vaccines & immunotherapeutics · 2026Article
- Temporal trends in viral setpoint and peak CD4 + cell count soon after HIV-1 seroconversion.AIDS (London, England) · 2026Observational
- Integration of HIV Status in Cancer Surveillance in South Africa: A Call for Action.Cancer medicine · 2026Article
- Estimating the burden of mpox among MSM in South Africa.BMJ global health · 2025Article
- A comparative assessment of CD4 recovery in a cohort of patients on different HAART regimens in a Nigerian tertiary healthcare facility.African health sciences · 2024Article
- Point of Care CD4 Testing in National Household Surveys - Results and Quality Indicators from Eleven Population-Based HIV Impact Assessment (PHIA) Surveys.Microbiology spectrum · 2023Article
- Hypertension in people living with HIV on combined antiretroviral therapy in rural Tanzania.African health sciences · 2023Article
- Molecular epidemiology and HIV-1 variant evolution in Poland between 2015 and 2019.Scientific reports · 2021Article
- Article
- Effect of Traditional Chinese Medicine Therapy on the Trend in CD4Evidence-based complementary and alternative medicine : eCAM · 2021Article
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- Establishment of reference range of CD4 T-lymphocyte in healthy Nepalese adults.BMC research notes · 2020Article
- Enhanced immunovirological response in women compared to men after antiretroviral therapy initiation during acute and early HIV-1 infection: results from a longitudinal study in the French ANRS Primo cohort.Journal of the International AIDS Society · 2020Article
- Characteristics and outcomes of older people on antiretroviral therapy in Tlokwe Clinics, South Africa.Southern African journal of HIV medicine · 2020Article
- Assessment of Pattern of CD4+ T-Cell Recovery Among Human Immunodeficiency Virus Patients After Initiation of Highly Active Antiretroviral Therapy at Arsi Negelle Health Center, Ethiopia: A Retrospective Cross-Sectional Study.HIV/AIDS (Auckland, N.Z.) · 2020Article
- Environmental distribution of certain modified live-virus vaccines with a high safety profile presents a low-risk, high-reward to control zoonotic diseases.Scientific reports · 2019Article
- Projected population-wide impact of antiretroviral therapy-linked isoniazid preventive therapy in a high-burden setting.AIDS (London, England) · 2019Article
- Lymphoid tissue fibrosis is associated with impaired vaccine responses.The Journal of clinical investigation · 2018Article
- Progress towards the UNAIDS 90-90-90 goals by age and gender in a rural area of KwaZulu-Natal, South Africa: a household-based community cross-sectional survey.BMC public health · 2018Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundLittle is known about the variability of CD4 counts in the general population of sub-Saharan Africa countries affected by the HIV epidemic. We investigated factors associated with CD4 counts in a rural area in South Africa with high HIV prevalence and high antiretroviral treatment (ART) coverage.
methodsCD4 counts, health status, body mass index (BMI), demographic characteristics and HIV status were assessed in 4990 adult resident participants of a demographic surveillance in rural KwaZulu-Natal in South Africa; antiretroviral treatment duration was obtained from a linked clinical database. Multivariable regression analysis, overall and stratified by HIV status, was performed with CD4 count levels as outcome.
resultsMedian CD4 counts were significantly higher in women than in men overall (714 vs. 630 cells/µl, p<0.0001), both in HIV-uninfected (833 vs. 683 cells/µl, p<0.0001) and HIV-infected adults (384.5 vs. 333 cells/µl, p<0.0001). In multivariable regression analysis, women had 19.4% (95% confidence interval (CI) 16.1-22.9) higher CD4 counts than men, controlling for age, HIV status, urban/rural residence, household wealth, education, BMI, self-reported tuberculosis, high blood pressure, other chronic illnesses and sample processing delay. At ART initiation, HIV-infected adults had 21.7% (95% CI 14.6-28.2) lower CD4 counts than treatment-naive individuals; CD4 counts were estimated to increase by 9.2% (95% CI 6.2-12.4) per year of treatment.
conclusionsCD4 counts are primarily determined by sex in HIV-uninfected adults, and by sex, age and duration of antiretroviral treatment in HIV-infected adults. Lower CD4 counts at ART initiation in men could be a consequence of lower CD4 cell counts before HIV acquisition.
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