ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
CD4+ T-Cell Count at Antiretroviral Therapy Initiation in the "Treat-All" Era in Rural South Africa: An Interrupted Time Series Analysis.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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18 citing papers in PubMed, 22 citations in OpenAlex.
- Therapeutic HIV-1 Tat vaccination promotes durable immune reconstitution and reservoir reduction in ART-treated adults with clade C infection: a 12-year follow-up study.Frontiers in immunology · 2026Trial
- Early HIV treatment and survival over six years of observation in the ANRS 12249 Treatment as Prevention Trial.HIV medicine · 2022Trial
- Association of Immunodeficiency and HIV Viremia With Cervical Precancer and Cancer Risk Among Women With HIV in South Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Determinants of CD4 count recovery among severely immunosuppressed HIV patients initiated on antiretroviral therapy: a prospective cohort study in KwaZulu-Natal, South Africa.Frontiers in public health · 2026Article
- Temporal trends in tuberculosis and time from enrolment in care to antiretroviral therapy initiation: A multicountry cohort study from Latin America.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025Article
- Global Trends in CD4 Count Measurement and Distribution at First Antiretroviral Treatment Initiation.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Impact of increasing CD4 count threshold eligibility for antiretroviral therapy initiation on advanced HIV disease and tuberculosis prevalence and incidence in South Africa: an interrupted time series analysis.BMJ global health · 2025Article
- 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
- The Effectiveness of Antiretroviral Therapy in Mitigating New HIV Infections in Southwest China: An Ecological Study.Infection and drug resistance · 2025Article
- Marginal structural Cox model for estimating the effect of Chinese medicine on the survival of people living with HIV: a 17-year real-world retrospective cohort study.Frontiers in public health · 2025Article
- The impact of tobacco smoking and smoking cessation on lung cancer and stroke incidence among people with HIV on antiretroviral therapy in South Africa: a simulation modeling study.BMJ global health · 2024Article
- Tobacco smoking, smoking cessation and life expectancy among people with HIV on antiretroviral therapy in South Africa: a simulation modelling study.Journal of the International AIDS Society · 2024Article
- Immunologic, virologic and drug resistance outcomes in an HIV-infected prospective cohort on treatment in South Africa.PloS one · 2024Observational
- Immediate and long-term outcomes after treat-all among people living with HIV in China: an interrupted time series analysis.Infectious diseases of poverty · 2023Article
- Article
- Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome-An Extempore Game of Misfiring with Defense Arsenals.Pathogens (Basel, Switzerland) · 2023Review
- Characteristics and clinical outcomes of patients presenting with advanced HIV disease in the "treat all" era: a retrospective cohort study from rural Rwanda.BMC infectious diseases · 2022Article
- CD4 Cell Count: A Critical Tool in the Human Immunodeficiency Virus Response.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
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14 authors at 9 institutions in 5 countries.
Funding
Abstract
backgroundSouth Africa implemented universal test and treat (UTT) in September 2016 in an effort to encourage earlier initiation of antiretroviral therapy (ART).
methodsWe therefore conducted an interrupted time series (ITS) analysis to assess the impact of UTT on mean CD4 count at ART initiation among adults aged ≥16 years attending 17 public sector primary care clinics in rural South Africa, between July 2014 and March 2019.
resultsAmong 20 599 individuals (69% women), CD4 counts were available for 74%. Mean CD4 at ART initiation increased from 317.1 cells/μL (95% confidence interval [CI], 308.6 to 325.6) 1 to 8 months prior to UTT to 421.0 cells/μL (95% CI, 413.0 to 429.0) 1 to 12 months after UTT, including an immediate increase of 124.2 cells/μL (95% CI, 102.2 to 146.1). However, mean CD4 count subsequently fell to 389.5 cells/μL (95% CI, 381.8 to 397.1) 13 to 30 months after UTT but remained above pre-UTT levels. Men initiated ART at lower CD4 counts than women (-118.2 cells/μL, 95% CI, -125.5 to -111.0) throughout the study.
conclusionsAlthough UTT led to an immediate increase in CD4 count at ART initiation in this rural community, the long-term effects were modest. More efforts are needed to increase initiation of ART early in those living with human immunodeficiency virus, particularly men.
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