1. Naseem Cassim Lindi Marie Coetzee Debbie Glencross
Analyzing trends in patient age and gender for CD4 testing in South Africa between 2010 and 2014
Naseem Cassim
Lindi Marie Coetzee
Debbie Glencross

2. Background
NHLS performs 4 million CD4 tests annually through a network of ~60 laboratories.
CD4 data provides an assessment immunological status for patient’s in HIV care.
Study aim:
To use routinely collected laboratory data to analyze age and gender trends.

3. Methods
CD4 laboratory data for the 2010 and 2014 calendar years (n=7.1m) were extracted from the corporate data warehouse (CDW).
Age and gender values are routinely captured in the laboratory information system (LIS).
Patient ages were categorized based on the ante-natal survey ranges.
CD4 absolute count was categorized based on ART guidelines.
Data was analyzed using Stata.
Data analysis included age and gender frequencies, CD4 test ranges and median CD4.

4. Results Gender distribution with Median CD4
Age Distribution with Median CD4
CD4 Test Range Distribution by Gender

5. Gender distribution and Median CD4
29% (n=933k) of CD4 specimens were from males in 2010, increasing to 31% (n=1199k) by 2014 (2% increase).
The male median CD4 in 2010 was 258 increasing to 336 cells/µl by 2014.
The female median CD4 increased from 323 in 2010 to 442 cells/µl in 2014.

6. Age Distribution
Significant uptake in testing for patients between 20 and 24 years (increasing from 66k in 2010 to 239k by 2014) – 350% increase.
A decrease in testing for patients greater that 49 years (6% reduction) was noted.
Overall, specimens from patients aged 15 to 29 years reported a twofold increase in testing.

7. Median CD4 by Age Category
The median CD4 increased for all age categories between 2010 and 2014 except for the range.
Significant Median CD4 increase was noted for patients over 35 years (+- increase of 100 cells/µl)

8. Gender CD4 Test Range Distribution
Overall, there was a significant increase in the proportion of CD4 results >= 500 cells/µl :
Females: 17% increase
Male: 9% increase

9. Conclusion
Study reported a small uptake of CD4 testing from males (2%), and a twofold increase for patients between 15 and 29 years.
Median CD4 increased across all age groups, except for the adolescent group.
Median CD4 increase reported is an indication of the effectiveness of ART and/or increased awareness resulting in healthier patients presenting for Pre-ART care.