Validation of a Simple and Cost-Effective Test for Enumeration of CD4 Cells

To the Editors: The enumeration of absolute count of CD4 cells has become an essential part of staging and monitoring HIV infection and for the initiation of antiretroviral therapy. In many developing countries, the high cost of the conventional CD4 tests is an obstacle to their use and a barrier to treatment.The available CD4 testing systems, based on flow cytometry, require expensive instrumentation and infrastructure and are time consuming. Hence, there is a need for rapid, lowcost, point-of-care, CD4 test, especially in primary health care centers. The objective of this study was to validate the Alere PIMA CD4 test system (Alere, CA), claimed to be a robust, affordable, and easy-to-use point-of-care assay using a battery-operated, portable, benchtop, fixed-volume cytometer that could be a highly effective tool in improving access to CD4 tests.