WHO HIV clinical staging or CD4 cell counts for antiretroviral therapy eligibility assessment? An evaluation in rural Rakai district, Uganda.

The ability of WHO clinical staging to predict CD4 cell counts of 200 cells/microl or less was evaluated among 1221 patients screened for antiretroviral therapy (ART). Sensitivity was 51% and specificity was 88%. The positive predictive value was 64% and the negative predictive value was 81%. Clinical criteria missed half the patients with CD4 cell counts of 200 cells/microl or less, highlighting the importance of CD4 cell measurements for the scale-up of ART provision in resource-limited settings.