KAIS 2007 1 - Kenya National AIDS & STI Control Programme ...

The Ministry of Medical Services has recommended that people with HIV who have a CD4 countof less than 250 cells/μL should initiate ARVs. 4 An estimated 214,000 HIV‐infected adults had CD4counts of less than 250 cells/μL but were not taking ARVs and were thus eligible to initiatetreatment. This figure likely underestimates ARV eligibility because the survey did not collectWHO clinical staging information. That is, some infected but untreated individuals with CD4counts of 250 cells/μL or greater with WHO stage III or IV disease may have been eligible to beginARV therapy but are not counted here.An additional 144,000 infected adults who did not report that there were taking ARVs had CD4cell counts of 250‐349 cells/μL, indicating possible ARV eligibility depending on clinical status.Moreover, the Ministry of Medical Services could change ARV eligibility guidelines in the futureto a criterion of less than 350 cells/μL, regardless of WHO stage, given that this cut off is usedwidely in other countries. Currently, Ministry of Medical Services guidelines recommend thatasymptomatic patients in this group be observed and monitored regularly.The remaining 69.8% of untreated HIV‐infected adults, an estimated 825,000 persons nationwide,had CD4 counts of 350 cells/μL or greater, which will decline over time and necessitate ARVmedications in the future.What is a CD4 Count?DATA IN CONTEXTCD4+ lymphocytes (also called CD4 cells or T4-cells) are an important part of theimmune system that lead the attack against infections. As HIV infectionprogresses, the number of CD4 cells is depleted. A laboratory test can measure theconcentration of CD4 cells in a person’s body. A normal CD4 cell count usually is>500 cells/μL. Lower CD4 counts are associated with increased risk ofcomplicating infections, cancers and death. The Ministry of Medical Servicescurrently recommends that all HIV-infected adults with a CD4 count of