Initiating antiretroviral treatment in a resource-constrained setting: does clinical staging effectively identify patients in need?
Identifieur interne : 000553 ( PubMed/Checkpoint ); précédent : 000552; suivant : 000554Initiating antiretroviral treatment in a resource-constrained setting: does clinical staging effectively identify patients in need?
Auteurs : K. Torpey [Zambie] ; M. Lartey ; R. Amenyah ; N A Addo ; J. Obeng-Baah ; Y. Rahman ; C. Suzuki ; Y D Mukadi ; R. ColebundersSource :
- International journal of STD & AIDS [ 0956-4624 ] ; 2009.
Descripteurs français
- KwdFr :
- Adulte, Agents antiVIH (administration et posologie), Agents antiVIH (usage thérapeutique), Détermination de l'admissibilité (), Femelle, Ghana (épidémiologie), Humains, Infections à VIH (immunologie), Infections à VIH (physiopathologie), Infections à VIH (traitement médicamenteux), Mâle, Numération des lymphocytes CD4, Pays en voie de développement, Population rurale, Population urbaine, Sensibilité et spécificité, Valeur prédictive des tests, Évaluation des besoins.
- MESH :
- administration et posologie : Agents antiVIH.
- immunologie : Infections à VIH.
- physiopathologie : Infections à VIH.
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Agents antiVIH.
- épidémiologie : Ghana.
- Adulte, Détermination de l'admissibilité, Femelle, Humains, Mâle, Numération des lymphocytes CD4, Pays en voie de développement, Population rurale, Population urbaine, Sensibilité et spécificité, Valeur prédictive des tests, Évaluation des besoins.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Adult, Anti-HIV Agents (administration & dosage), Anti-HIV Agents (therapeutic use), CD4 Lymphocyte Count, Developing Countries, Eligibility Determination (methods), Female, Ghana (epidemiology), HIV Infections (drug therapy), HIV Infections (immunology), HIV Infections (physiopathology), Humans, Male, Needs Assessment, Predictive Value of Tests, Rural Population, Sensitivity and Specificity, Urban Population.
- MESH :
- chemical , administration & dosage : Anti-HIV Agents.
- chemical , therapeutic use : Anti-HIV Agents.
- geographic , epidemiology : Ghana.
- drug therapy : HIV Infections.
- immunology : HIV Infections.
- methods : Eligibility Determination.
- physiopathology : HIV Infections.
- Adult, CD4 Lymphocyte Count, Developing Countries, Female, Humans, Male, Needs Assessment, Predictive Value of Tests, Rural Population, Sensitivity and Specificity, Urban Population.
Abstract
In industrialized countries, the initiation of antiretroviral therapy (ART) is based on virological, immunological and clinical markers. The objective of this study was to identify treatment gaps when ART initiation is based on clinical staging alone. The method employed was a retrospective study of 5784 patients enrolled in an HIV treatment programme in two urban and two rural sites in Ghana. Of the patients, 29.5% were in clinical Stages I and II and had a CD4+ T-lymphocyte count less than 200 cells/mm(3). Significantly more patients in clinical Stage I from urban sites (37.0%) had a CD4+ T-lymphocyte count less than 200 cells/mm(3) as compared with patients from rural sites (23.8%) (P value <0.05). In addition, more men (39.9%) in clinical Stage I had a CD4+ T-lymphocyte count less than 200 cells/mm(3) when compared with women (27.4%) (P value <0.05). In conclusion, clinical staging cannot identify a relatively large number of patients who need ART. A wider availability of CD4+ T-lymphocyte count testing will optimize the identification of patients eligible for ART.
DOI: 10.1258/ijsa.2008.008333
PubMed: 19451324
Affiliations:
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The objective of this study was to identify treatment gaps when ART initiation is based on clinical staging alone. The method employed was a retrospective study of 5784 patients enrolled in an HIV treatment programme in two urban and two rural sites in Ghana. Of the patients, 29.5% were in clinical Stages I and II and had a CD4+ T-lymphocyte count less than 200 cells/mm(3). Significantly more patients in clinical Stage I from urban sites (37.0%) had a CD4+ T-lymphocyte count less than 200 cells/mm(3) as compared with patients from rural sites (23.8%) (P value <0.05). In addition, more men (39.9%) in clinical Stage I had a CD4+ T-lymphocyte count less than 200 cells/mm(3) when compared with women (27.4%) (P value <0.05). In conclusion, clinical staging cannot identify a relatively large number of patients who need ART. A wider availability of CD4+ T-lymphocyte count testing will optimize the identification of patients eligible for ART.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">19451324</PMID><DateCreated><Year>2009</Year><Month>05</Month><Day>19</Day></DateCreated><DateCompleted><Year>2009</Year><Month>08</Month><Day>04</Day></DateCompleted><DateRevised><Year>2009</Year><Month>05</Month><Day>19</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0956-4624</ISSN><JournalIssue CitedMedium="Print"><Volume>20</Volume><Issue>6</Issue><PubDate><Year>2009</Year><Month>Jun</Month></PubDate></JournalIssue><Title>International journal of STD & AIDS</Title><ISOAbbreviation>Int J STD AIDS</ISOAbbreviation></Journal><ArticleTitle>Initiating antiretroviral treatment in a resource-constrained setting: does clinical staging effectively identify patients in need?</ArticleTitle><Pagination><MedlinePgn>395-8</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1258/ijsa.2008.008333</ELocationID><Abstract><AbstractText>In industrialized countries, the initiation of antiretroviral therapy (ART) is based on virological, immunological and clinical markers. The objective of this study was to identify treatment gaps when ART initiation is based on clinical staging alone. The method employed was a retrospective study of 5784 patients enrolled in an HIV treatment programme in two urban and two rural sites in Ghana. Of the patients, 29.5% were in clinical Stages I and II and had a CD4+ T-lymphocyte count less than 200 cells/mm(3). Significantly more patients in clinical Stage I from urban sites (37.0%) had a CD4+ T-lymphocyte count less than 200 cells/mm(3) as compared with patients from rural sites (23.8%) (P value <0.05). In addition, more men (39.9%) in clinical Stage I had a CD4+ T-lymphocyte count less than 200 cells/mm(3) when compared with women (27.4%) (P value <0.05). In conclusion, clinical staging cannot identify a relatively large number of patients who need ART. A wider availability of CD4+ T-lymphocyte count testing will optimize the identification of patients eligible for ART.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Torpey</LastName><ForeName>K</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Family Health International, Lusaka, Zambia. Ktorpey@zpct.org</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lartey</LastName><ForeName>M</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Amenyah</LastName><ForeName>R</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Addo</LastName><ForeName>N A</ForeName><Initials>NA</Initials></Author><Author ValidYN="Y"><LastName>Obeng-Baah</LastName><ForeName>J</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Rahman</LastName><ForeName>Y</ForeName><Initials>Y</Initials></Author><Author ValidYN="Y"><LastName>Suzuki</LastName><ForeName>C</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Mukadi</LastName><ForeName>Y D</ForeName><Initials>YD</Initials></Author><Author ValidYN="Y"><LastName>Colebunders</LastName><ForeName>R</ForeName><Initials>R</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Int J STD AIDS</MedlineTA><NlmUniqueID>9007917</NlmUniqueID><ISSNLinking>0956-4624</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019380">Anti-HIV Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CitationSubset>X</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019380" MajorTopicYN="N">Anti-HIV Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018791" MajorTopicYN="N">CD4 Lymphocyte Count</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003906" MajorTopicYN="Y">Developing Countries</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004608" MajorTopicYN="N">Eligibility Determination</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005869" MajorTopicYN="N" Type="Geographic">Ghana</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015658" MajorTopicYN="Y">HIV Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020380" MajorTopicYN="N">Needs Assessment</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011237" MajorTopicYN="N">Predictive Value of Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012424" MajorTopicYN="N">Rural Population</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012680" MajorTopicYN="N">Sensitivity and Specificity</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014505" MajorTopicYN="N">Urban Population</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2009</Year><Month>5</Month><Day>20</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2009</Year><Month>5</Month><Day>20</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2009</Year><Month>8</Month><Day>6</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">19451324</ArticleId><ArticleId IdType="pii">20/6/395</ArticleId><ArticleId IdType="doi">10.1258/ijsa.2008.008333</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Zambie</li></country></list><tree><noCountry><name sortKey="Addo, N A" sort="Addo, N A" uniqKey="Addo N" first="N A" last="Addo">N A Addo</name><name sortKey="Amenyah, R" sort="Amenyah, R" uniqKey="Amenyah R" first="R" last="Amenyah">R. Amenyah</name><name sortKey="Colebunders, R" sort="Colebunders, R" uniqKey="Colebunders R" first="R" last="Colebunders">R. Colebunders</name><name sortKey="Lartey, M" sort="Lartey, M" uniqKey="Lartey M" first="M" last="Lartey">M. Lartey</name><name sortKey="Mukadi, Y D" sort="Mukadi, Y D" uniqKey="Mukadi Y" first="Y D" last="Mukadi">Y D Mukadi</name><name sortKey="Obeng Baah, J" sort="Obeng Baah, J" uniqKey="Obeng Baah J" first="J" last="Obeng-Baah">J. Obeng-Baah</name><name sortKey="Rahman, Y" sort="Rahman, Y" uniqKey="Rahman Y" first="Y" last="Rahman">Y. Rahman</name><name sortKey="Suzuki, C" sort="Suzuki, C" uniqKey="Suzuki C" first="C" last="Suzuki">C. Suzuki</name></noCountry><country name="Zambie"><noRegion><name sortKey="Torpey, K" sort="Torpey, K" uniqKey="Torpey K" first="K" last="Torpey">K. Torpey</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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