ArticlePloS one2020
Proportions of CD4 test results indicating advanced HIV disease remain consistently high at primary health care facilities across four high HIV burden countries.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 22 citations in OpenAlex.
- Point-of-care CD4 testing: Differentiated care for the most vulnerable.Journal of global health · 2022Trial
- Evaluation of the diagnostic validity of the HIV VISITECT CD4 point-of-care rapid diagnostic test in Uganda.BMC infectious diseases · 2026Article
- Advanced HIV disease among newly diagnosed clients identified through community- and facility-based HIV testing services in Eswatini: a cross-sectional study.Frontiers in public health · 2026Article
- Burden and predictors of advanced HIV disease among people living with HIV at Zewditu Memorial Hospital in Addis Ababa, Ethiopia.Frontiers in public health · 2026Article
- Sociodemographic and Clinical Determinants of Adults With Advanced HIV Disease on Antiretroviral Therapy in West Oromia, Ethiopia: A Hospital-Based Retrospective Study.AIDS research and treatment · 2026Article
- Characteristics of Individuals With Advanced HIV Disease and Risk Factors for Mortality in a Contemporary Cohort in South Africa.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Clinical impact and cost-effectiveness of the WHO-recommended advanced HIV disease package of care.The Lancet. Global health · 2025Article
- Global prevalence of advanced HIV disease in healthcare settings: a rapid review.Journal of the International AIDS Society · 2025Review
- Monitoring for advanced disease in the universal test and treat era: trends in CD4 count testing in South Africa.BMC global and public health · 2025Article
- Standard of care in advanced HIV disease: review of HIV treatment guidelines in six sub-Saharan African countries.AIDS research and therapy · 2023Review
- Effect of Coronavirus Disease 2019 Lockdowns on Identification of Advanced Human Immunodeficiency Virus Disease in Outpatient Clinics in Uganda.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Persistent High Burden and Mortality Associated With Advanced HIV Disease in Rural Tanzania Despite Uptake of World Health Organization "Test and Treat" Guidelines.Open forum infectious diseases · 2022Article
- Article
- Diagnosis of human immunodeficiency virus associated disseminated intravascular coagulation.PloS one · 2022Article
- Factors Associated with Baseline CD4 Cell Counts and Advanced HIV Disease among Male and Female HIV-Positive Patients in Iran: A Retrospective Cohort Study.Journal of tropical medicine · 2022Article
- Improved detection and management of advanced HIV disease through a community adult TB-contact tracing intervention with same-day provision of the WHO-recommended package of care including ART initiation in a rural district of Mozambique.Journal of the International AIDS Society · 2021Article
- Changes Over Time in the Proportion of Advanced HIV Disease in Two High HIV Prevalence Settings in Ndhiwa (Kenya) and Eshowe (South Africa).Journal of the International Association of Providers of AIDS CareArticle
Corrections and comments
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Authors and funding
17 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundGlobally, nearly 22 million HIV-infected patients are currently accessing antiretroviral treatment; however, almost one million people living with HIV died of AIDS-related illnesses in 2018. Advanced HIV disease remains a significant issue to curb HIV-related mortality.
methodsWe analyzed 864,389 CD4 testing records collected by 1,016 Alere Pima Analyzers implemented at a variety of facilities, including peripheral facilities, between January 2012 and December 2016 across four countries in sub-Saharan Africa. Routinely collected data and programmatic records were used to analyze the median CD4 counts and proportions of patients with advanced HIV disease by country, facility type, and year.
resultsMedian CD4 counts were between 409-444 cells/ul each year since 2012 with a median in 2016 of 444 cells/ul (n = 319,829). The proportion of test results returning CD4 counts above 500 cells/ul has increased slowly each year with 41.8% (95% CI: 41.6-41.9%) of tests having a CD4 count above 500 cells/ul in 2016. Median CD4 counts were similar across facility types. The proportion of test results indicating advanced HIV disease has remained fairly consistent: 19.4% (95% CI: 18.8-20.1%) in 2012 compared to 16.1% (95% CI: 16.0-16.3%) in 2016. The proportion of test results indicating advanced HIV disease annually ranged from 14.5% in Uganda to 29.8% in Cameroon. 6.9% (95% CI: 6.8-7.0%) of test results showed very advanced HIV disease (CD4<100 cells/ul) in 2016.
conclusionsThe proportion of CD4 test results indicating advanced disease was relatively high and consistent across four high HIV burden countries.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.