Monitoring of human immunodeficiency virus infection in resource-constrained countries.

The reference standards used to monitor human immunodeficiency virus (HIV) infection are flow cytometric analysis of T lymphocyte subsets to provide the CD4+ T cell count and molecular assays to quantify plasma HIV load. Few laboratories in resource-constrained countries can afford to perform these tests. A number of lower-cost assays requiring less expensive equipment may be well-suited to such countries. These include manual CD4 cell assays (Dynal, Coulter, BioRad) and ultrasensitive reverse transcriptase (Cavidi) and p24 (Perkin Elmer Life Sciences) assays to monitor virus load. Quality control and access to quality assurance programs are essential. The total lymphocyte count, although readily available and inexpensive, generally does not correlate as closely with CD4+ T cell counts. Other surrogate markers, such as beta2-microglobulin, are not suitable for routine monitoring of HIV infection. This review discusses the above assays and their role in addition to clinical monitoring in resource-constrained countries.

[1]  C. Mahé,et al.  Progression to symptomatic disease in people infected with HIV-1 in rural Uganda: prospective cohort study. , 2002, BMJ : British Medical Journal.

[2]  G. Janossy,et al.  Affordable CD4+ T cell counts by flow cytometry. II. The use of fixed whole blood in resource-poor settings. , 2001, Journal of immunological methods.

[3]  H. Joller,et al.  Antiretroviral treatment monitoring with an improved HIV‐1 p24 antigen test: an inexpensive alternative to tests for viral RNA , 2001, Journal of medical virology.

[4]  C. Okany,et al.  Absolute lymphocyte count as surrogate for CD4+ cell count in monitoring response to antiretroviral therapy. , 2001, The Nigerian postgraduate medical journal.

[5]  G. Maartens,et al.  Initiating co-trimoxazole prophylaxis in HIV-infected patients in Africa: an evaluation of the provisional WHO/UNAIDS recommendations , 2001, AIDS.

[6]  P. Ghys,et al.  Human immunodeficiency virus Type 1 (HIV-1) plasma virus load and markers of immune activation among HIV-infected female sex workers with sexually transmitted diseases in Abidjan, Côte d'Ivoire. , 2001, The Journal of infectious diseases.

[7]  T. F. Rinke de Wit,et al.  Plasma levels of viro-immunological markers in HIV-infected and non-infected Ethiopians: correlation with cell surface activation markers. , 2001, Clinical immunology.

[8]  M D Kazatchkine,et al.  Comparative assessment of five alternative methods for CD4+ T-lymphocyte enumeration for implementation in developing countries. , 2001, Journal of acquired immune deficiency syndromes.

[9]  George Janossy,et al.  Affordable CD4(+) T-cell counts on 'single-platform' flow cytometers I. Primary CD4 gating. , 2000 .

[10]  N. Villamor,et al.  Enumeration of CD4(+) T-cells in the peripheral blood of HIV-infected patients: an interlaboratory study of the FACSCount system. , 1999, Cytometry.

[11]  A. P. D. Ponce de Leon,et al.  Surrogate markers of disease progression in HIV-infected children in Rio de Janeiro, Brazil. , 1999, Journal of tropical pediatrics.

[12]  J. Karon,et al.  Efficacy of trimethoprim-sulphamethoxazole prophylaxis to decrease morbidity and mortality in HIV-1-infected patients with tuberculosis in Abidjan, Côte d'Ivoire: a randomised controlled trial , 1999, The Lancet.

[13]  T. F. Rinke de Wit,et al.  Evaluation of the World Health Organization staging system for HIV infection and disease in Ethiopia: association between clinical stages and laboratory markers. , 1999, AIDS.

[14]  H. Dahourou,et al.  Evaluation of a quantitative determination of CD4 and CD8 molecules as an alternative to CD4 + and CD8 + T lymphocyte counts in Africans , 1999, Tropical medicine & international health : TM & IH.

[15]  A. Coutts,et al.  Haematologic features of the human immunodeficiency virus (HIV) infection in adult Zimbabweans. , 1999, The Central African journal of medicine.

[16]  J. Baggs,et al.  Impact of HIV type 1 subtype variation on viral RNA quantitation. , 1999, AIDS research and human retroviruses.

[17]  M. Peeters,et al.  Efficiencies of Four Versions of the AMPLICOR HIV-1 MONITOR Test for Quantification of Different Subtypes of Human Immunodeficiency Virus Type 1 , 1999, Journal of Clinical Microbiology.

[18]  B. Pau,et al.  Whole blood capcellia CD4/CD8 immunoassay for enumeration of CD4+ and CD8+ peripheral T lymphocytes. , 1999, Clinical chemistry.

[19]  E. van der Ryst,et al.  Correlation among total lymphocyte count, absolute CD4+ count, and CD4+ percentage in a group of HIV-1-infected South African patients. , 1998, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[20]  M. Bendinelli,et al.  A colorimetric reverse transcriptase assay optimized for Moloney murine leukemia virus, and its use for characterization of reverse transcriptases of unknown identity. , 1998, Journal of virological methods.

[21]  C. Gibert,et al.  Weight loss as a predictor of survival and disease progression in HIV infection. Terry Beirn Community Programs for Clinical Research on AIDS. , 1998, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[22]  A. Fattorossi,et al.  Quantification of the variation due to lysing technique in immunophenotyping of healthy and HIV-infected individuals. , 1998, Clinical biochemistry.

[23]  E. De Clercq,et al.  Failure to quantify viral load with two of the three commercial methods in a pregnant woman harboring an HIV type 1 subtype G strain. , 1998, AIDS research and human retroviruses.

[24]  J. Kaldor,et al.  Predictors of Progression in Long-Term Nonprogressors , 1998 .

[25]  J. Kaldor,et al.  Predictors of progression in long-term nonprogressors. Australian Long-Term Nonprogressor Study Group. , 1998, AIDS research and human retroviruses.

[26]  H. Whittle,et al.  Immune stimulation by syphilis and malaria in HIV-2-infected and uninfected villagers in West Africa. , 1997, British journal of biomedical science.

[27]  J. Margolick,et al.  Helper T-lymphocyte count. TRAx CD4 test kit versus conventional flow cytometry. , 1997, Archives of pathology & laboratory medicine.

[28]  T. Sirisanthana,et al.  Flow cytometric analysis of T-lymphocytes subsets in adult Thais. , 1997, Asian Pacific journal of allergy and immunology.

[29]  P. Campbell,et al.  Decrease in CD4 lymphocyte counts with rest; implications for the monitoring of HIV infection , 1997, International journal of STD & AIDS.

[30]  J. Albert,et al.  Subtype‐specific problems with quantification of plasma HIV‐1 RNA , 1997, AIDS.

[31]  S. Cousens,et al.  CD4+ T-lymphocyte counts in HIV infection: are European standards applicable to African patients? , 1997, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[32]  J. C. Hudson,et al.  A whole blood alternative to traditional methods for CD4+ T lymphocyte determination. , 1997, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[33]  S. Crowe,et al.  Comparison of branched DNA and reverse transcriptase polymerase chain reaction for quantifying six different HIV-1 subtypes in plasma. , 1997, AIDS.

[34]  E. Beck,et al.  Correlation between total and CD4 lymphocyte counts in HIV infection: not making the good an enemy of the not so perfect , 1996, International journal of STD & AIDS.

[35]  K. Pallangyo,et al.  Evaluation of the FACScount, TRAx CD4 and Dynabeads methods for CD4 lymphocyte determination. , 1996, Journal of immunological methods.

[36]  J. Böni,et al.  Heat‐mediated immune complex dissociation and enzyme‐linked immunosorbent assay signal amplification render p24 antigen detection in plasma as sensitive as HIV‐1 RNA detection by polymerase chain reaction , 1996, AIDS.

[37]  Comparison of absolute CD4+ lymphocyte counts determined by enzyme immunoassay (TRAx CD4 test kit) and flow cytometry , 1996, Clinical and diagnostic laboratory immunology.

[38]  G. Maartens,et al.  CD4 and total lymphocyte counts as predictors of HIV disease progression. , 1996, QJM : monthly journal of the Association of Physicians.

[39]  D. Hirschkorn,et al.  Evaluation of four alternative methodologies for determination of absolute CD4+ lymphocyte counts. The National Heart, Lung, and Blood Institute Retrovirus Epidemiology Donor Study. , 1995, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[40]  M. Hirsch,et al.  Potential clinical implications of interlaboratory variability in CD4+ T-lymphocyte counts of patients infected with human immunodeficiency virus. , 1995, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[41]  T. Quinn,et al.  A manual bead assay for the determination of absolute CD4+ and CD8+ lymphocyte counts in human immunodeficiency virus-infected individuals , 1995, Clinical and diagnostic laboratory immunology.

[42]  S. Gillespie,et al.  Clinical Features and Serum β2-Microglobulin Levels in HIV-1 Positive and Negative Tanzanian Patients with Tuberculosis , 1995, International journal of STD & AIDS.

[43]  J. Montaner,et al.  Use of the Markov model to estimate the waiting times in a modified WHO staging system for HIV infection. , 1995, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[44]  J. Phair,et al.  Comparison of CD4 cell count by a simple enzyme-linked immunosorbent assay using the TRAx CD4 test kit and by flow cytometry and hematology , 1995, Clinical and diagnostic laboratory immunology.

[45]  O. Ferreira,et al.  A Rapid and Reliable Assay to Enumerate CD4+ T Lymphocytes in Whole Blood , 1994, Journal of acquired immune deficiency syndromes.

[46]  M. Schechter,et al.  Predicting CD4 counts in HIV-infected Brazilian individuals: a model based on the World Health Organization staging system. , 1994, Journal of Acquired Immune Deficiency Syndromes.

[47]  D. Hom,et al.  A rapid manual method for CD4+ T-cell quantitation for use in developing countries , 1993, AIDS.

[48]  C. Hendrix,et al.  Total lymphocyte count as a predictor of absolute CD4+ count and CD4+ percentage in HIV-infected persons. , 1993, JAMA.

[49]  J. Montaner,et al.  Application of the World Health Organization system for HIV infection in a cohort of homosexual men in developing a prognostically meaningful staging system , 1992, AIDS.

[50]  J. Carlin,et al.  Predictive value of CD4 lymphocyte numbers for the development of opportunistic infections and malignancies in HIV-infected persons. , 1991, Journal of acquired immune deficiency syndromes.

[51]  J. Malone,et al.  Sources of variability in repeated T-helper lymphocyte counts from human immunodeficiency virus type 1-infected patients: total lymphocyte count fluctuations and diurnal cycle are important. , 1990, Journal of acquired immune deficiency syndromes.