The BD FACSPresto Point of Care CD4 Test Accurately Enumerates CD4+ T Cell Counts.
OBJECTIVE:Currently 50% of ART eligible patients are not yet receiving life-saving antiretroviral therapy (ART). Financial constraints do not allow most developing countries to adopt a universal test and offer ART strategy. Decentralizing CD4+ T cell testing may, therefore, provide greater access to...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4697849?pdf=render |
| _version_ | 1818338762411737088 |
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| author | Priska Bwana Lara Vojnov Maureen Adhiambo Catherine Akinyi Joy Mwende Marta Prescott Matilu Mwau |
| author_facet | Priska Bwana Lara Vojnov Maureen Adhiambo Catherine Akinyi Joy Mwende Marta Prescott Matilu Mwau |
| author_sort | Priska Bwana |
| collection | DOAJ |
| description | OBJECTIVE:Currently 50% of ART eligible patients are not yet receiving life-saving antiretroviral therapy (ART). Financial constraints do not allow most developing countries to adopt a universal test and offer ART strategy. Decentralizing CD4+ T cell testing may, therefore, provide greater access to testing, ART, and better patient management. We evaluated the technical performance of a new point-of-care CD4+ T cell technology, the BD FACSPresto, in a field methods comparison study. METHODS:264 HIV-positive patients were consecutively enrolled and included in the study. The BD FACSPresto POC CD4+ T cell technology was placed in two rural health care facilities and operated by health care facility staff. We compared paired finger-prick and venous samples using the BD FACSPresto and several existing reference technologies, respectively. RESULTS:The BD FACSPresto had a mean bias of 67.29 cells/ul and an r(2) of 0.9203 compared to the BD FACSCalibur. At ART eligibility thresholds of 350 and 500 cells/ul, the sensitivity to define treatment eligibility were 81.5% and 77.2% and the specificities were 98.9% and 100%, respectively. Similar results were observed when the BD FACSPresto was compared to the BD FACSCount and Alere Pima. The coefficient of variation (CV) was less than 7% for both the BD FACSCalibur and BD FACSPresto. CD4+ T cell testing by nurses using the BD FACSPresto at rural health care facilities showed high technical similarity to test results generated by laboratory technicians using the BD FACSPresto in a high functioning laboratory. CONCLUSIONS:The BD FACSPresto performed favorably in the laboratory setting compared to the conventional reference standard technologies; however, the lower sensitivities indicated that up to 20% of patients tested in the field in need of treatment would be missed. The BD FACSPresto is a technology that can allow for greater decentralization and wider access to CD4+ T cell testing and ART. |
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| format | Article |
| id | doaj.art-7f5999ae3294447dab6a261e9b092c8d |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T15:16:16Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj.art-7f5999ae3294447dab6a261e9b092c8d2022-12-21T23:40:41ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-011012e014558610.1371/journal.pone.0145586The BD FACSPresto Point of Care CD4 Test Accurately Enumerates CD4+ T Cell Counts.Priska BwanaLara VojnovMaureen AdhiamboCatherine AkinyiJoy MwendeMarta PrescottMatilu MwauOBJECTIVE:Currently 50% of ART eligible patients are not yet receiving life-saving antiretroviral therapy (ART). Financial constraints do not allow most developing countries to adopt a universal test and offer ART strategy. Decentralizing CD4+ T cell testing may, therefore, provide greater access to testing, ART, and better patient management. We evaluated the technical performance of a new point-of-care CD4+ T cell technology, the BD FACSPresto, in a field methods comparison study. METHODS:264 HIV-positive patients were consecutively enrolled and included in the study. The BD FACSPresto POC CD4+ T cell technology was placed in two rural health care facilities and operated by health care facility staff. We compared paired finger-prick and venous samples using the BD FACSPresto and several existing reference technologies, respectively. RESULTS:The BD FACSPresto had a mean bias of 67.29 cells/ul and an r(2) of 0.9203 compared to the BD FACSCalibur. At ART eligibility thresholds of 350 and 500 cells/ul, the sensitivity to define treatment eligibility were 81.5% and 77.2% and the specificities were 98.9% and 100%, respectively. Similar results were observed when the BD FACSPresto was compared to the BD FACSCount and Alere Pima. The coefficient of variation (CV) was less than 7% for both the BD FACSCalibur and BD FACSPresto. CD4+ T cell testing by nurses using the BD FACSPresto at rural health care facilities showed high technical similarity to test results generated by laboratory technicians using the BD FACSPresto in a high functioning laboratory. CONCLUSIONS:The BD FACSPresto performed favorably in the laboratory setting compared to the conventional reference standard technologies; however, the lower sensitivities indicated that up to 20% of patients tested in the field in need of treatment would be missed. The BD FACSPresto is a technology that can allow for greater decentralization and wider access to CD4+ T cell testing and ART.http://europepmc.org/articles/PMC4697849?pdf=render |
| spellingShingle | Priska Bwana Lara Vojnov Maureen Adhiambo Catherine Akinyi Joy Mwende Marta Prescott Matilu Mwau The BD FACSPresto Point of Care CD4 Test Accurately Enumerates CD4+ T Cell Counts. PLoS ONE |
| title | The BD FACSPresto Point of Care CD4 Test Accurately Enumerates CD4+ T Cell Counts. |
| title_full | The BD FACSPresto Point of Care CD4 Test Accurately Enumerates CD4+ T Cell Counts. |
| title_fullStr | The BD FACSPresto Point of Care CD4 Test Accurately Enumerates CD4+ T Cell Counts. |
| title_full_unstemmed | The BD FACSPresto Point of Care CD4 Test Accurately Enumerates CD4+ T Cell Counts. |
| title_short | The BD FACSPresto Point of Care CD4 Test Accurately Enumerates CD4+ T Cell Counts. |
| title_sort | bd facspresto point of care cd4 test accurately enumerates cd4 t cell counts |
| url | http://europepmc.org/articles/PMC4697849?pdf=render |
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