Impact on ART initiation of point-of-care CD4 testing at HIV diagnosis among HIV-positive youth in Khayelitsha, South Africa.
Identifieur interne : 001171 ( PubMed/Curation ); précédent : 001170; suivant : 001172Impact on ART initiation of point-of-care CD4 testing at HIV diagnosis among HIV-positive youth in Khayelitsha, South Africa.
Auteurs : Gabriela E M. Patten [Afrique du Sud] ; Lynne Wilkinson ; Karien Conradie ; Petros Isaakidis ; Anthony D. Harries ; Mary E. Edginton ; Virginia De Azevedo ; Gilles Van CutsemSource :
- Journal of the International AIDS Society [ 1758-2652 ] ; 2013.
Descripteurs français
- KwdFr :
- Antirétroviraux (administration et posologie), Facteurs temps, Femelle, Grossesse, Humains, Infections à VIH (diagnostic), Infections à VIH (traitement médicamenteux), Jeune adulte, Mâle, Numération des lymphocytes CD4 (), République d'Afrique du Sud, Soins ambulatoires (), Soins ambulatoires (organisation et administration), Systèmes automatisés lit malade, Études de cohortes.
- MESH :
- administration et posologie : Antirétroviraux.
- diagnostic : Infections à VIH.
- organisation et administration : Soins ambulatoires.
- traitement médicamenteux : Infections à VIH.
- Facteurs temps, Femelle, Grossesse, Humains, Jeune adulte, Mâle, Numération des lymphocytes CD4, République d'Afrique du Sud, Soins ambulatoires, Systèmes automatisés lit malade, Études de cohortes.
- Wicri :
- geographic : Afrique du Sud.
English descriptors
- KwdEn :
- Ambulatory Care (methods), Ambulatory Care (organization & administration), Anti-Retroviral Agents (administration & dosage), CD4 Lymphocyte Count (methods), Cohort Studies, Female, HIV Infections (diagnosis), HIV Infections (drug therapy), Humans, Male, Point-of-Care Systems, Pregnancy, South Africa, Time Factors, Young Adult.
- MESH :
- chemical , administration & dosage : Anti-Retroviral Agents.
- geographic : South Africa.
- diagnosis : HIV Infections.
- drug therapy : HIV Infections.
- methods : Ambulatory Care, CD4 Lymphocyte Count.
- organization & administration : Ambulatory Care.
- Cohort Studies, Female, Humans, Male, Point-of-Care Systems, Pregnancy, Time Factors, Young Adult.
Abstract
Despite the rapid expansion of antiretroviral therapy (ART) programmes in developing countries, pre-treatment losses from care remain a challenge to improving access to treatment. Youth and adolescents have been identified as a particularly vulnerable group, at greater risk of loss from both pre-ART and ART care. Point-of-care (POC) CD4 testing has shown promising results in improving linkage to ART care. In Khayelitsha township, South Africa, POC CD4 testing was implemented at a clinic designated for youth aged 12-25 years. We assessed whether there was an associated reduction in attrition between HIV testing, assessment for eligibility and ART initiation.
PubMed: 23830642
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Patten</name><affiliation wicri:level="1"><nlm:affiliation>MSF Khayelitsha, Cape Town, South Africa. gem.patten@gmail.com</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>MSF Khayelitsha, Cape Town</wicri:regionArea></affiliation></author><author><name sortKey="Wilkinson, Lynne" sort="Wilkinson, Lynne" uniqKey="Wilkinson L" first="Lynne" last="Wilkinson">Lynne Wilkinson</name></author><author><name sortKey="Conradie, Karien" sort="Conradie, Karien" uniqKey="Conradie K" first="Karien" last="Conradie">Karien Conradie</name></author><author><name sortKey="Isaakidis, Petros" sort="Isaakidis, Petros" uniqKey="Isaakidis P" first="Petros" last="Isaakidis">Petros Isaakidis</name></author><author><name sortKey="Harries, Anthony D" sort="Harries, Anthony D" uniqKey="Harries A" first="Anthony D" last="Harries">Anthony D. Harries</name></author><author><name sortKey="Edginton, Mary E" sort="Edginton, Mary E" uniqKey="Edginton M" first="Mary E" last="Edginton">Mary E. Edginton</name></author><author><name sortKey="De Azevedo, Virginia" sort="De Azevedo, Virginia" uniqKey="De Azevedo V" first="Virginia" last="De Azevedo">Virginia De Azevedo</name></author><author><name sortKey="Van Cutsem, Gilles" sort="Van Cutsem, Gilles" uniqKey="Van Cutsem G" first="Gilles" last="Van Cutsem">Gilles Van Cutsem</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2013">2013</date><idno type="RBID">pubmed:23830642</idno><idno type="pmid">23830642</idno><idno type="wicri:Area/PubMed/Corpus">001171</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001171</idno><idno type="wicri:Area/PubMed/Curation">001171</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001171</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Impact on ART initiation of point-of-care CD4 testing at HIV diagnosis among HIV-positive youth in Khayelitsha, South Africa.</title><author><name sortKey="Patten, Gabriela E M" sort="Patten, Gabriela E M" uniqKey="Patten G" first="Gabriela E M" last="Patten">Gabriela E M. Patten</name><affiliation wicri:level="1"><nlm:affiliation>MSF Khayelitsha, Cape Town, South Africa. gem.patten@gmail.com</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>MSF Khayelitsha, Cape Town</wicri:regionArea></affiliation></author><author><name sortKey="Wilkinson, Lynne" sort="Wilkinson, Lynne" uniqKey="Wilkinson L" first="Lynne" last="Wilkinson">Lynne Wilkinson</name></author><author><name sortKey="Conradie, Karien" sort="Conradie, Karien" uniqKey="Conradie K" first="Karien" last="Conradie">Karien Conradie</name></author><author><name sortKey="Isaakidis, Petros" sort="Isaakidis, Petros" uniqKey="Isaakidis P" first="Petros" last="Isaakidis">Petros Isaakidis</name></author><author><name sortKey="Harries, Anthony D" sort="Harries, Anthony D" uniqKey="Harries A" first="Anthony D" last="Harries">Anthony D. Harries</name></author><author><name sortKey="Edginton, Mary E" sort="Edginton, Mary E" uniqKey="Edginton M" first="Mary E" last="Edginton">Mary E. Edginton</name></author><author><name sortKey="De Azevedo, Virginia" sort="De Azevedo, Virginia" uniqKey="De Azevedo V" first="Virginia" last="De Azevedo">Virginia De Azevedo</name></author><author><name sortKey="Van Cutsem, Gilles" sort="Van Cutsem, Gilles" uniqKey="Van Cutsem G" first="Gilles" last="Van Cutsem">Gilles Van Cutsem</name></author></analytic><series><title level="j">Journal of the International AIDS Society</title><idno type="eISSN">1758-2652</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Ambulatory Care (methods)</term><term>Ambulatory Care (organization & administration)</term><term>Anti-Retroviral Agents (administration & dosage)</term><term>CD4 Lymphocyte Count (methods)</term><term>Cohort Studies</term><term>Female</term><term>HIV Infections (diagnosis)</term><term>HIV Infections (drug therapy)</term><term>Humans</term><term>Male</term><term>Point-of-Care Systems</term><term>Pregnancy</term><term>South Africa</term><term>Time Factors</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Antirétroviraux (administration et posologie)</term><term>Facteurs temps</term><term>Femelle</term><term>Grossesse</term><term>Humains</term><term>Infections à VIH (diagnostic)</term><term>Infections à VIH (traitement médicamenteux)</term><term>Jeune adulte</term><term>Mâle</term><term>Numération des lymphocytes CD4 ()</term><term>République d'Afrique du Sud</term><term>Soins ambulatoires ()</term><term>Soins ambulatoires (organisation et administration)</term><term>Systèmes automatisés lit malade</term><term>Études de cohortes</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Anti-Retroviral Agents</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>South Africa</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Antirétroviraux</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Ambulatory Care</term><term>CD4 Lymphocyte Count</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Soins ambulatoires</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Ambulatory Care</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Point-of-Care Systems</term><term>Pregnancy</term><term>Time Factors</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Facteurs temps</term><term>Femelle</term><term>Grossesse</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Numération des lymphocytes CD4</term><term>République d'Afrique du Sud</term><term>Soins ambulatoires</term><term>Systèmes automatisés lit malade</term><term>Études de cohortes</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Afrique du Sud</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Despite the rapid expansion of antiretroviral therapy (ART) programmes in developing countries, pre-treatment losses from care remain a challenge to improving access to treatment. Youth and adolescents have been identified as a particularly vulnerable group, at greater risk of loss from both pre-ART and ART care. Point-of-care (POC) CD4 testing has shown promising results in improving linkage to ART care. In Khayelitsha township, South Africa, POC CD4 testing was implemented at a clinic designated for youth aged 12-25 years. We assessed whether there was an associated reduction in attrition between HIV testing, assessment for eligibility and ART initiation.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">23830642</PMID><DateCreated><Year>2013</Year><Month>07</Month><Day>08</Day></DateCreated><DateCompleted><Year>2013</Year><Month>11</Month><Day>11</Day></DateCompleted><DateRevised><Year>2015</Year><Month>04</Month><Day>23</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1758-2652</ISSN><JournalIssue CitedMedium="Internet"><Volume>16</Volume><PubDate><Year>2013</Year><Month>Jul</Month><Day>04</Day></PubDate></JournalIssue><Title>Journal of the International AIDS Society</Title><ISOAbbreviation>J Int AIDS Soc</ISOAbbreviation></Journal><ArticleTitle>Impact on ART initiation of point-of-care CD4 testing at HIV diagnosis among HIV-positive youth in Khayelitsha, South Africa.</ArticleTitle><Pagination><MedlinePgn>18518</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.7448/IAS.16.1.18518</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Despite the rapid expansion of antiretroviral therapy (ART) programmes in developing countries, pre-treatment losses from care remain a challenge to improving access to treatment. Youth and adolescents have been identified as a particularly vulnerable group, at greater risk of loss from both pre-ART and ART care. Point-of-care (POC) CD4 testing has shown promising results in improving linkage to ART care. In Khayelitsha township, South Africa, POC CD4 testing was implemented at a clinic designated for youth aged 12-25 years. We assessed whether there was an associated reduction in attrition between HIV testing, assessment for eligibility and ART initiation.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A before-and-after observational study was conducted using routinely collected data. These were collected on patients from May 2010 to April 2011 (Group A) when baseline CD4 count testing was performed in a laboratory and results were returned to the clinic within two weeks. Same-day POC CD4 testing was implemented in June 2011, and data were collected on patients from August 2011 to July 2012 (Group B).</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 272 and 304 youth tested HIV-positive in Group A and Group B, respectively. Group B patients were twice as likely to have their ART eligibility assessed compared to Group A patients: 275 (90%) vs. 183 (67%) [relative risk (RR)=2.4, 95% CI: 1.8-3.4, p<0.0001]. More patients in World Health Organization (WHO) Stage 1 disease (85% vs. 69%), with CD4 counts≥350 cells/µL (58% vs. 35%) and more males (13% vs. 7%) were detected in Group B. The proportion of eligible patients who initiated ART was 50% and 44% (p=0.6) in Groups B and A, respectively; and 50% and 43% (p=0.5) when restricted to patients with baseline CD4 count≤250 cells/µL. Time between HIV-testing and ART initiation was reduced from 36 to 28 days (p=0.6).</AbstractText><AbstractText Label="DISCUSSION" NlmCategory="CONCLUSIONS">POC CD4 testing significantly improved assessment for ART eligibility. The improvement in the proportion initiating ART and the reduction in time to initiation was not significant due to sample size limitations.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">POC CD4 testing reduced attrition between HIV-testing and assessment of ART eligibility. Strategies to improve uptake of ART are needed, possibly by improving patient support for HIV-positive youth immediately after diagnosis.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Patten</LastName><ForeName>Gabriela E M</ForeName><Initials>GE</Initials><AffiliationInfo><Affiliation>MSF Khayelitsha, Cape Town, South Africa. gem.patten@gmail.com</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wilkinson</LastName><ForeName>Lynne</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Conradie</LastName><ForeName>Karien</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Isaakidis</LastName><ForeName>Petros</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Harries</LastName><ForeName>Anthony D</ForeName><Initials>AD</Initials></Author><Author ValidYN="Y"><LastName>Edginton</LastName><ForeName>Mary E</ForeName><Initials>ME</Initials></Author><Author ValidYN="Y"><LastName>De Azevedo</LastName><ForeName>Virginia</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>van Cutsem</LastName><ForeName>Gilles</ForeName><Initials>G</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D023362">Evaluation Studies</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2013</Year><Month>07</Month><Day>04</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>J Int AIDS Soc</MedlineTA><NlmUniqueID>101478566</NlmUniqueID><ISSNLinking>1758-2652</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D044966">Anti-Retroviral Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CitationSubset>X</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>AIDS Res Hum Retroviruses. 2007 Oct;23(10):1208-14</RefSource><PMID Version="1">17961106</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Acquir Immune Defic Syndr. 2009 May 1;51(1):65-71</RefSource><PMID Version="1">19282780</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>PLoS One. 2010;5(3):e9538</RefSource><PMID Version="1">20209059</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>PLoS Med. 2011 Jul;8(7):e1001056</RefSource><PMID Version="1">21811403</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Trop Med Int Health. 2012 Dec;17(12):1509-20</RefSource><PMID Version="1">22994151</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Acquir Immune Defic Syndr. 2011 Oct 1;58(2):193-7</RefSource><PMID Version="1">21826014</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2011 Oct 29;378(9802):1572-9</RefSource><PMID Version="1">21951656</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>AIDS. 2012 Oct 23;26(16):2059-67</RefSource><PMID Version="1">22781227</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Acquir Immune Defic Syndr. 2011 Nov 1;58(3):e54-9</RefSource><PMID Version="1">21857356</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000553" MajorTopicYN="N">Ambulatory Care</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName><QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D044966" MajorTopicYN="N">Anti-Retroviral Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018791" MajorTopicYN="N">CD4 Lymphocyte Count</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015658" MajorTopicYN="N">HIV Infections</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019095" MajorTopicYN="Y">Point-of-Care Systems</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011247" MajorTopicYN="N">Pregnancy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013019" MajorTopicYN="N" Type="Geographic">South Africa</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">PMC3702919</OtherID><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">HIV/AIDS</Keyword><Keyword MajorTopicYN="N">South Africa</Keyword><Keyword MajorTopicYN="N">antiretroviral therapy</Keyword><Keyword MajorTopicYN="N">attrition</Keyword><Keyword MajorTopicYN="N">operational research</Keyword><Keyword MajorTopicYN="N">point-of-care CD4 testing</Keyword><Keyword MajorTopicYN="N">pre-antiretroviral therapy care</Keyword><Keyword MajorTopicYN="N">youth and adolescents</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2012</Year><Month>12</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2013</Year><Month>05</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2013</Year><Month>06</Month><Day>06</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>7</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2013</Year><Month>7</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2013</Year><Month>11</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">23830642</ArticleId><ArticleId IdType="pii">18518</ArticleId><ArticleId 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