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How best to deploy point-of-care CD4 cell testing in resource-limited settings?
Theo Smart, 2011-07-19 06:50:00
Widespread introduction of point-of-care (POC) CD4 cell tests that don’t require a laboratory technician but can be performed onsite by a nurse, providing results in less than an hour – while the patient waits) is expected in the next 12 to 24 months, said Dr Steven Reid of Imperial College, London, during a session on advances in diagnostics on Monday at the International AIDS Society conference in Rome, Italy.
In fact, one such test is already being rolled out in some settings. Speakers during the session described how POC CD4 tests might improve service delivery for people living with HIV, their potential cost-effectiveness and where best to deploy them.
For instance, the availability of POC CD4 cell tests – paired with a mobile HIV counselling and testing service – significantly increased linkage to care for people testing positive for HIV, according to one study.
Dr Reid presented a modelling study suggesting that starting treatment on the basis of POC results would be more cost-effective than with traditional CD4 cell tests, and better than initiating treatment on the basis of clinical (syndromic) management of people living with HIV — potentially adding years to their lives.
However, another study, presented by Dr Ilesh V Jani of the Instituto Nacional de Saúde reported that the cost of implementing POC CD4 would depend upon the clinic and volume of tests it would perform — and that there should be “a more judicial deployment of the technology", prioritising “higher volume sites and clinics that cannot refer samples to laboratories”.
Source:1
