CD4 Cell Count at Antiretroviral Therapy Initiation or Re- Initiation

This study is part of a multi-regional IeDEA study across four African regions to assess the burden of advanced HIV disease among PLWH at ART initiation and re-initiation. Among adults and adolescents. The WHO defines advanced HIV disease as having a CD4 cell count <200 cells/uL or having WHO stage 3 or 4 disease. In our region we aim to enrol 500 participants aged 18 years and older and we will conduct a cross-sectional evaluation that will include assessments of WHO clinical stage, CD4 cell count, and ART exposure status at enrolment/re-enrolment into care, as well as barriers to HIV testing and care.

In addition, we will extract routinely collected clinical data on all study participants from within the cohort dataset, including prospective data on participant treatment outcomes, and CD4 and HIV VL measurements performed as part of routine patient care. These data will be harmonized using the IeDEA-DES, which is a common data model for sharing observational HIV data designed and maintained by the Data Harmonization Working Group (DHWG) of IeDEA.

Inclusion criteria

• All adults aged ≥18 years who are willing and able to provide consent and are: newly enrolling in HIV care and starting ART at study sites OR
• re-enrolling after a known ≥24-month ART gap confirmed by clinic records or patient recall at eligibility screening.

Exclusion criteria

• Patients known to be on ART for more than 7 days at the time of assessment for enrollment into study.
• Patients with a gap in ART that is <24 months.
• Patients with a gap in ART of unknown duration