CD4 counts and viral loads of newly diagnosed HIV-infected individuals: implications for treatment as prevention

PLoS One. 2014 Mar 4;9(3):e90754. doi: 10.1371/journal.pone.0090754. eCollection 2014.

Abstract

Objective: To report the viral load and CD4 count in HIV-infected, antiretroviral naïve, first -time HIV-testers, not immediately eligible for treatment initiation by current South Africa treatment guidelines.

Design: This was a cross-sectional study in a high-volume, free-of-charge HIV testing centre in Soweto, South Africa.

Methods: We enrolled first time HIV testers and collected demographic and risk-behaviour data and measured CD4 count and viral load.

Results: Between March and October 2011, a total of 4793 adults attended VCT and 1062 (22%) tested positive. Of the 1062, 799 (75%) were ART naïve and 348/799 (44%) were first-time HIV testers. Of this group of 348, 225 (65%) were female. Overall their median age, CD4 count and viral load was 34 years (IQR: 28-41), 364 (IQR: 238-542) cells/mm3 and 13,000 (IQR: 2050-98171) copies/ml, respectively. Female first time HIV testers had higher CD4 counts (419 IQR: 262-582 vs. 303 IQR: 199-418 cells/mm3) and lower viral loads (9,100 vs. 34,000 copies/ml) compared to males. Of 183 participants with CD4 count >350 cells/mm3, 62 (34%) had viral loads > 10,000 copies/ml.

Conclusions: A large proportion of HIV infected adults not qualifying for immediate ART at the CD4 count threshold of 350 cells/mm3 have high viral loads. HIV-infected men at their first HIV diagnosis are more likely to have lower CD4 counts and higher viral loads than women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count*
  • Cross-Sectional Studies
  • Female
  • HIV / isolation & purification*
  • HIV Infections / diagnosis*
  • HIV Infections / epidemiology
  • HIV Infections / immunology*
  • HIV Infections / prevention & control
  • Humans
  • Male
  • Middle Aged
  • South Africa / epidemiology
  • Viral Load*

Grants and funding

This study was funded by Canadian African Prevention Trials Network (CAPT) and Presidents Emergency Plan For AIDS Relief (PEPFAR). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. KO has received research training from the Fogarty International Center (TW007373/0).