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Regional differences in predictive accuracy of WHO immunologic failure criteria

Kiragga, Agnes N.a; Castelnuovo, Barbaraa; Kamya, Moses R.a,b; Moore, Richardc; Manabe, Yukari C.a,c

doi: 10.1097/QAD.0b013e32835143e3
Research Letters

We compared the performance of the WHO immunologic criteria for treatment failure among Uganda and American patients. Antiretroviral treatment-naive patients with a CD4 T-cell count less than 200 cells/μl or AIDS at enrollment on a nonnucleoside reverse transcriptase inhibitors-based regimen for more than 1 year were selected. For all criteria, the positive predictive value was significantly higher in the American compared with the Ugandan patients. Population-specific guidelines should be developed using large African cohorts to identify more specific and sensitive criteria.

aCollege of Health Sciences, Infectious Diseases Institute

bDepartment of Medicine, College of Health Sciences, Makerere University Kampala, Uganda

cJohns Hopkins Bloomberg School of Public Health, Divisions of Infectious Diseases and Clinical Pharmacology, Baltimore, MD, USA.

Correspondence to Agnes N. Kiragga, College of Health Sciences, Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda. Tel: +256 414307200; fax: +256 414307290; e-mail:

Received 19 September, 2011

Revised 2 January, 2012

Accepted 10 January, 2012

© 2012 Lippincott Williams & Wilkins, Inc.