What is the role of CD4 count in a large public health antiretroviral programme?

Copyright: © 2016. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License. HIV clinicians have relied on the CD4 count for more than three decades as being central to key issues in managing HIV-positive patients. The CD4 count is an important predictor of disease progression1,2,3,4,5 and death,6,7,8 and has informed us when to start antiretroviral therapy (ART), opportunistic infection (OI) risk stratification (especially in late presenting patients), when to start and stop OI prophylaxis or management, as well as in monitoring response to treatment.8,9,10 However, in areas where viral loads are readily available and patients are virologically suppressed and stable, the question arises – is there a role for continued CD4 count monitoring in this setting?