How regular should HIV positive patients on Antiretrovirals in a Resource constrained settings do CD4 count and Viral load tests ?
Check these links
http://apps.who.int/iris/bitstream/10665/246200/1/9789241511124-eng.pdf?ua=1
http://www.who.int/bulletin/volumes/90/12/12-102780/en/
http://www.who.int/hiv/pub/journal_articles/09_optimal_ARV_monitoring_strategies.pdf
The frequency of viral load monitoring is patient specific and depends on characteristics such as patient's engagement in care, medication adherence history, level of resistance in their viral population, but usually ranges from 3 to 6 months, but a shorter interval may be appropriate following a medication change. The frequency of CD4 monitoring also is patient specific and may depend on whether medications have been initiated or recently changed. Engaged patients may find increases in CD4 reassuring and thus hearing these numbers may contribute to their commitment to 100% adherence. Certainly more frequent testing of CD4 is appropriate if near a decision point regarding OI prevention. However, testing more frequently than every 3 months is not well justified when the numbers are not near a decision point. Once they have climbed to normal levels or if well above absolute counts of 200 and percentages of 14%, these values do not appear to affect medical decisions. Less frequent testing is the current trend, and the question of whether additional measurements are necessary is still open.
recommend that your HIV care provider order a CD4 test every 3 to 6 months when the patient is under ART.
On routine basis one can do six monthly CD4 and annually viral load in resource limited setting and above that whenever indicated
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