oa South African Medical Journal - Time to reduce CD4+ monitoring for the management of antiretroviral therapy in HIV-infected individuals - : editorial

Volume 104, Issue 8
  • ISSN : 0256-9574
  • E-ISSN: 2078-5135



The relative importance of laboratory monitoring in HIV/AIDS programmes in low- and middle-income countries has been the subject of considerable debate over the past decade. The recent changes in South Africa (SA)'s HIV treatment guidelines focus primarily on maintaining a low viral load (VL) (preferably undetectable VL: <40 copies/ml) to reduce the risk of transmission and drug resistance. Monitoring of HIV/AIDS and associated opportunistic infections represents a significant challenge to resource-limited countries, where the potential total cost of disease monitoring may exceed the annual health budget. Many obstacles are noted in the provision of affordable and accessible laboratory monitoring for HIV/AIDS, including limited laboratory infrastructure, absence of technical skills, high reagent costs and large capital outlay costs for sophisticated equipment.

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