Timing of blood sampling for CD4 T-cell counting influences HAART decisions

Ethiop Med J. 2011 Jul;49(3):187-97.

Abstract

Background: Variability in CD4 T-cell counts has been described for both healthy and HIV-infected persons. It may influence decisions with respect to initiation and monitoring of antiretroviral treatment.

Objective: to measure the effect of timing of blood sampling for blood cell count measurement.

Method: The study population consisted of 71 Ethiopian patients in an observational cohort, either being monitored prior to HAART (n = 40) or receiving HAART (n = 31) at an ART Clinic in Addis Ababa.

Result: The median CD4 count demonstrated significantly increasing trends from the morning (8 am) to the afternoon (4 pm), both for patients on HAART (increase of 137 CD4 cell/microl; p = 0.003) and for patients initiating HAART (increase of 56 CD4 cells/microl; p = 0.038). This trend was also observed for CD8+ and CD3+ T-lymphocytes, (initiating HAART p = 0.002 and p = 0.001; patients on HAART p = 0.015 and p = 0.004, respectively).

Conclusion: The implications of these findings are for the decision to start HAART or the decision to start prevention of opportunistic infections in Ethiopian patients on HAART.

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active
  • Blood Specimen Collection / methods*
  • CD4 Lymphocyte Count*
  • CD4-Positive T-Lymphocytes
  • Cohort Studies
  • Decision Making
  • Ethiopia
  • Female
  • HIV Infections / blood*
  • HIV Infections / drug therapy
  • Humans
  • Immunophenotyping
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods*
  • RNA, Viral / blood
  • Sex Factors
  • Time Factors
  • Viral Load

Substances

  • RNA, Viral