RESEARCH PAPER
Simultaneous HIV and lymphocyte CD4+ testing as an intervention for improving linkage to care – experience of a voluntary counselling and testing facility-based pilot programme
Submission date: 2017-04-07
Final revision date: 2017-11-23
Acceptance date: 2018-01-18
Publication date: 2018-03-13
HIV & AIDS Review 2018;17(1):8-11
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Simultaneous lymphocyte CD4+ and HIV testing has been proposed as a method for shortening the time between human immunodeficency syndrome (HIV) diagnosis and combined anti¬retroviral therapy (cART) initiation, thus improving clinical outcomes. Here, we investigate its impact on the linkage to care in voluntary counselling and testing centers (VCT) in Warsaw.
Material and methods:
All clients, who presented at the two VCTs in Warsaw and had positive ELISA tests, were offered the lymphocyte CD4+ test simultaneously with the WB test. All tests were anonymous. Data collected between 2012-2013 from the VCTs were linked with HIV clinic records using the WB test numbers as unique identifiers. Persons registered in HIV clinics were considered linked to care.
Results:
In total, during 2012-2013, one hundred and twenty-three clients were tested as HIV-positive in the VCTs. Of these, 30 had their lymphocyte CD4+ count tested, while 42 (65.8%) clients were linked to HIV care. The linkage rate did not differ between the lymphocyte CD4+ test groups (66.7% of tested vs. 65.6% of non-tested for the lymphocyte CD4+; p = 0.91). There was also no significant difference in time to linkage, p = 0.52. In total, 66 (65.8%) clients started cART – 19 (28.8%) in the lymphocyte CD4+ group, and 47 (71.2%) in other (p = 0.07). However, there was a significant difference in the time for starting cART, p = 0.005.
Conclusions:
In Poland, a resource-rich country, simultaneous lymphocyte CD4+ and HIV testing at counselling and testing centers had no effect on linkage to care, but did have a positive impact on time to starting cART.
Simultaneous lymphocyte CD4+ and HIV testing has been proposed as a method for shortening the time between human immunodeficency syndrome (HIV) diagnosis and combined anti¬retroviral therapy (cART) initiation, thus improving clinical outcomes. Here, we investigate its impact on the linkage to care in voluntary counselling and testing centers (VCT) in Warsaw.
Material and methods:
All clients, who presented at the two VCTs in Warsaw and had positive ELISA tests, were offered the lymphocyte CD4+ test simultaneously with the WB test. All tests were anonymous. Data collected between 2012-2013 from the VCTs were linked with HIV clinic records using the WB test numbers as unique identifiers. Persons registered in HIV clinics were considered linked to care.
Results:
In total, during 2012-2013, one hundred and twenty-three clients were tested as HIV-positive in the VCTs. Of these, 30 had their lymphocyte CD4+ count tested, while 42 (65.8%) clients were linked to HIV care. The linkage rate did not differ between the lymphocyte CD4+ test groups (66.7% of tested vs. 65.6% of non-tested for the lymphocyte CD4+; p = 0.91). There was also no significant difference in time to linkage, p = 0.52. In total, 66 (65.8%) clients started cART – 19 (28.8%) in the lymphocyte CD4+ group, and 47 (71.2%) in other (p = 0.07). However, there was a significant difference in the time for starting cART, p = 0.005.
Conclusions:
In Poland, a resource-rich country, simultaneous lymphocyte CD4+ and HIV testing at counselling and testing centers had no effect on linkage to care, but did have a positive impact on time to starting cART.
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| eISSN: | 1732-2707 |
| ISSN: | 1730-1270 |
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