Prueba piloto de validación del método portátil PIMA para el recuento de células CD4 en comparación con la citometría de flujo / Pilot validation study of the PIMA portatil platform for the CD4 T-cell enumeration compared to flux cytometry

Objetivo: comparar la metodología PIMA con la citometría de flujo convencional para el recuento de linfocitos CD4 en pacientes con infección por HIV. Métodos: se realizaron determinaciones pareadas en sangre veno-sa de pacientes con HIV y se comparó la correlación entre ambos re-sultados. Resultados: se realizaron 223 determinaciones en forma pareadas. La concordancia fue muy buena, con una correlación lineal de Pear-son de 0,974, correlación por rangos de Spearman de 0,971 y con un coeficiente de determinación lineal (R cuadrado) de 0,949 (p < 0,01). El coeficiente de correlación intraclases para las medidas individua-les fue de 0,965 (IC 95 % 0,926-0,980) y para medidas promedio 0,982 (IC95 % 0,961-0,990). El coeficiente de variación para medidas duplicadas fue bajo siendo 11,4 %.Discusión: este estudio demuestra una buena correlación entre la de-terminación de células CD4 con el sistema PIMA frente a la citometría de flujo y apoya el uso de estas metodologías donde no hay acceso a citometría convencional

Objective: To compare PIMA methodology to the standard CD4 FACSCalibur flow cytometry for CD4 testing. Method: Paired blood samples were collectedamong HIV patients and tested using PIMA and Becton Dickinson FACSCalibur. Results: 223 samples were studied in parallel. There was a high concordance, being Pearson Linear Correlation 0.974, the Spearman Rank Correlation Coefficient 0.971. The Intraclass Correlation Coefficient for individual measures was 0.965 (95%CI 0.926-0.980) and for average measures 0.982 (95%CI 0.961-0.990). There was a low coefficient of variation from duplicate measurements (11.4%).Conclusion: This study shows a good correlation between the PIMA CD4 count and the Becton Dickinson FACSCalibur. By being a point of care methodology that produces same-day results, PIMA CD4 might be an alternative for sites without access to standard CD4 count methodology

Routine HIV testing among hospitalized patients in Argentina. is it time for a policy change?

INTRODUCTION: The Argentinean AIDS Program estimates that 110,000 persons are living with HIV/AIDS in Argentina. Of those, approximately 40% are unaware of their status, and 30% are diagnosed in advanced stages of immunosuppression. Though studies show that universal HIV screening is cost-effective in settings with HIV prevalence greater than 0.1%, in Argentina, with the exception of antenatal care, HIV testing is always client-initiated. OBJECTIVE: We performed a pilot study to assess the acceptability of a universal HIV screening program among inpatients of an urban public hospital in Buenos Aires. METHODS: Over a six-month period, all eligible adult patients admitted to the internal medicine ward were offered HIV testing. Demographics, uptake rates, reasons for refusal and new HIV diagnoses were analyzed. RESULTS: Of the 350 admissions during this period, 249 were eligible and subsequently enrolled. The enrolled population was relatively old compared to the general population, was balanced on gender, and did not report traditional high risk factors for HIV infection. Only 88 (39%) reported prior HIV testing. One hundred and ninety (76%) patients accepted HIV testing. In multivariable analysis only younger age (OR 1.02; 95%CI 1.003-1.05) was independently associated with test uptake. Three new HIV diagnoses were made (undiagnosed HIV prevalence: 1.58%); none belonged to a most-at-risk population. CONCLUSIONS: Our findings suggest that universal HIV screening in this setting is acceptable and potentially effective in identifying undiagnosed HIV-infected individuals. If confirmed in a larger study, our findings may inform changes in the Argentinean HIV testing policy.

Reactivación de tuberculosis pulmonar asociada a seroconversión al virus de inmunodeficiencia humana / Reactivation of Pulmonary Tuberculosis associated with Human Immunodeficiency Virus (HIV) seroconversion

Entre un 40-90% de los pacientes que adquieren la infección por HIV presentan un conjunto de síntomas durante el periodo de la seroconversión, habitualmente denominado "Síndrome Retroviral Agudo" (SRA)...

It is estimated that between 40 and 90% of HIV infected patients experience some sympotoms during HIV seroconversion, attributable to an acute retroviral syndrome (ARS)...

Reactivación de tuberculosis pulmonar asociada a seroconversión al virus de inmunodeficiencia humana / Reactivation of Pulmonary Tuberculosis associated with Human Immunodeficiency Virus (HIV) seroconversion

Entre un 40-90% de los pacientes que adquieren la infección por HIV presentan un conjunto de síntomas durante el periodo de la seroconversión, habitualmente denominado "Síndrome Retroviral Agudo" (SRA)...(AU)

It is estimated that between 40 and 90% of HIV infected patients experience some sympotoms during HIV seroconversion, attributable to an acute retroviral syndrome (ARS)...(AU)