1090. Validity of Self-Reported CD4+ Count Among HIV-infected Persons in Care
Session: Poster Abstract Session: HIV: Modeling and Education Around Antiretrovirals
Friday, October 9, 2015
Room: Poster Hall
Posters
  • IDWEEK_McPherson_Final[1].pdf (297.7 kB)
  • Background: Data on the validity of self-reported CD4+ counts in outpatient settings are limited. Validity of self-report would support its use as a quick, non-invasive, and affordable data source for research and clinical care.

    Methods: We conducted an observational study at the Vanderbilt Comprehensive Care Clinic (Nashville, TN) from August 2012 to March 2015. Patients with self-reported CD4+ data were included. Demographic and laboratory data were abstracted from medical records. CD4+ knowledge was a self-report value within 50 cells/μL of the immediate prior actual value. Relationship between self-reported and actual values was assessed by Spearman’s rank correlation. Odds ratios (OR) for lack of CD4+ knowledge were estimated by logistic regression.

    Results: There were 74 persons included; median age was 43, 72% were male, 57% were black. Median actual CD4+ count was 609 cells/μL (interquartile range [IQR]: 323-828). Median lag from actual to self-report value was 91 days (IQR: 18-126). Persons with CD4+ knowledge were similar to those without such knowledge regarding age, sex, race, injection drug use (IDU) as HIV risk factor, high school education/equivalent, actual CD4+ count, and year of enrollment in care. Of those able to recall a CD4+value (n=41, 55%), 33 (80%) had CD4+ knowledge. There was a 0.97 (p<0.001) correlation between self-reported and actual values. In adjusted analysis, black race and lag between self-reported and actual values were independently associated with lack of CD4+ knowledge (Table).

    Conclusion:

    In our study, self-reported CD4+ was correlated with the value obtained by chart review. These findings support the use of self-reported CD4+ counts for clinical care and research purposes when other methods are not available. Further study is needed to examine potential unmeasured confounders such as health literacy and numeracy.

    N=74

    Adjusted OR: Lack of CD4+ knowledge

    Age at CD4 self-report (years)

    1.00 (0.95-1.05)

    Male sex

    1.64 (0.50-5.33)

    Black race

    3.55 (1.16-10.88)

    IDU as HIV risk factor

    0.83 (0.16-4.43)

    High School Education or Equivalent

    0.23 (0.04-1.47)

    Actual CD4+ count (per 10 cells/μL)

    1.01 (0.99-1.02)

    Lag between actual and self-reported CD4+

    (per 7 days)

    0.95 (0.91-0.99)

    Year of enrollment in care

    0.97 (0.88-1.08)

    Tristan Mcpherson, MD, Internal Medicine & Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, Megan Turner, M.A, Department of Medicine, Division of Infectious Diseases, Vanderbilt University, Nashville, TN, Fernanda Maruri, MPH, Vanderbilt University, Nashville, TN, Peter Rebeiro, MHS, PhD, Vanderbilt University School of Medicine, Nashville, TN, Sally Bebawy, BS, Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, William Rogers, BS, Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, Lauren Brinkley-Rubinstein, PhD, Warren Alpert Medical School of Brown University, Providence, RI, Anna Person, MD, Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, Timothy R. Sterling, MD, FIDSA, Division of Infectious Diseases, Department of Medicine, Vanderbilt University, Nashville, TN and April Pettit, MD, MPH, Division of Infectious Diseases, Vanderbilt University, Nashville, TN

    Disclosures:

    T. Mcpherson, None

    M. Turner, None

    F. Maruri, None

    P. Rebeiro, None

    S. Bebawy, None

    W. Rogers, None

    L. Brinkley-Rubinstein, None

    A. Person, None

    T. R. Sterling, None

    A. Pettit, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.