Publications & Reports

Less frequent CD4 monitoring in virologically suppressed HIV.

McMahon J, Crowe SM


In The Lancet HIV , Ellen Caniglia and colleagues 1 provide further evidence to support reduction of the frequency of monitoring in HIV-infected individuals with suppressed viral load. The study, for which they should be commended, represents a detailed analysis from a large dataset from cohorts in western Europe and North and South America.

The question of whether T-cell counts and HIV viral load can be monitored less frequently is important for patients (who might initially be concerned about not having regular CD4 monitoring, but could benefit from less invasive monitoring), for clinicians (whose workloads would decrease), and for the health system (which might make substantial cost savings). Importantly, no randomised clinical trials from high-income country settings are available to guide decision making on the frequency of CD4 cell count and HIV RNA monitoring at different CD4 cell count thresholds for people who are on antiretroviral therapy, because such a randomised controlled trial would be costly and lengthy and might be considered unethical.


  • Journal: The Lancet HIV
  • Published: 01/06/2017
  • Volume: 4
  • Issue: 6
  • Pagination: e233-e234