Our Reflex CD4
Project

Reflex CD4 testing among people with HIV viraemia to determine the prevalence of advanced HIV disease.

Our Reflex CD4
Project

Reflex CD4 testing among people with HIV viraemia to determine the prevalence of advanced HIV disease.

Project Overview

Project title: Reflex CD4 testing among people with HIV viraemia to determine the prevalence of advanced HIV disease

The Reflex CD4 project is looking at new ways to identify people living with advanced HIV disease. It focuses on doing CD4 by “reflex” on anyone with a raised level of virus in their blood, otherwise known as ‘viraemic’. The study hypothesises that people living with HIV that have difficulties controlling the level of virus in their blood are at higher risk of being in an advanced stage of HIV so this project hopes to be able to identify this group earlier. The project is running out of a large laboratory in Johannesburg and aims to describe the incidence of advanced HIV disease in those with high levels of HIV in their blood.

Aim: To describe the prevalence of AHD among people with detectable HIV viral loads in Johannesburg by performing reflex CD4 using laboratory-based flow cytometry.

Key Objectives

  • To describe the CD4 distribution among people with detectable HIV viral loads.
  • To perform subgroup analyses by HIV VL strata (> 50 cps/mL, > 200 cps/mL, > 1000 cps/mL and by HIV log10.
  • To perform CD4 testing by qPCR and validate against laboratory-based flow cytometry testing.
  • To describe the prevalence of AHD among people with detectable HIV viral loads.
  • To describe the proportion of people found to have AHD who had a CD4 sample requested within the routine care programme.

Achievements

All relevant regulatory and ethics approvals obtained and sample enrolment has started.

Current Status

September 2025

Sample enrolment commenced in September 2025, with 1,000 samples enrolled as of December 2025.

March

Enrolment is expected to be completed by March 2026.

Team Members

  • David Lawrence

  • Lucia Hans

  • Johnny Falconer

  • Joseph Jarvis

  • Nelesh Govender

  • Lesley Scott

Media