Why AffordCD4

Why AffordCD4 ?

During the last decade we have watched, with horror, how HIV has spread to the developing world. Now 36 million people live with it. We have made CD4 and similar antibodies and used them in clinical routine service for >18 years. We have also learned that HIV therapy can be more effectively given when CD4+ T cell counts are monitored.

When we wish to use CD4 tests to monitor HIV disease and therapy we find that the methods currently used for flow cytometry unaffordable and in appropriate for resource-poor settings.

It is in the developing world where CD4 counts are the most important to perform. A CD4 count is the accepted test (i) for AIDS surveillance, (ii) for monitoring the rate of progression to AIDS, (iii) to define when therapy is required to prevent opportunistic infections, (iv) to place drug-naive patients into cohorts prior to therapy, and (v) to monitor the effects of anti-retroviral therapy and vaccination.

Are CD4 counts really impossible to introduce, in a more "economical but very accurate version", in the developing world?

There is another compelling reason why 'Affordable CD4' is essential. Commercial drug companies are keen to help but not much would be learned from haphazard distribution of drugs given away in open-ended undisciplined schemes. Considering dangers of developing drug resistance and side effects, patients may not benefit much in that way. Anti-retroviral therapy in developing countries will need to be linked, as in developed countries, to at least a minimal infrastructure for patient monitoring. Thus affordable CD4 enumeration will be required in resource-poor conditions - to promote the introduction of sensible therapy.

Can CD4 counts be genuinely affordable?