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Grey nails predict low CD4 cell count among untreated patients with HIV infection in Malawi

Scarborough, M., Gordon, Stephen ORCID: https://orcid.org/0000-0001-6576-1116, French, Neil, Phiri, C., Musaya, J. and Zijlstra, E. E. (2006) 'Grey nails predict low CD4 cell count among untreated patients with HIV infection in Malawi'. AIDS, Vol 20, Issue 10, pp. 1415-1417.

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Abstract

Background: Alternative criteria for initiating antiretroviral therapy to CD4 testing or clinical illness are needed in Malawi.
Method: We tested if grey nails could be used to identify patients with a CD4 cell count less than 200 cells/mu l who had not yet presented with AIDS-defining illnesses.
Results: Using a set of 242 photographs we showed good inter-observer agreement for grey nails (kappa = 0.66; P < 0.0001) and the positive predictive value of grey nails for a CD4 cell count of less than 200 cells/mu l was 81% (chi(2) < 0.0001).
Conclusions: Grey nails have been associated with HIV infection and we have shown significant correlation of this sign with a low CD4 cell count. For clinicians working in sub-Saharan Africa without access to CD4 cell count testing, grey or DB nails represent an additional staging sign to help identify a sub-group of patients likely to benefit from ART. (c) 2006 Lippincott Williams & Wilkins.

Item Type: Article
Uncontrolled Keywords: clinical staging nails hiv-1 aids anti-retroviral therapy
Subjects: WB Practice of Medicine > Diagnosis > General Diagnosis > WB 143 Signs and symptoms
WB Practice of Medicine > Diagnosis > General Diagnosis > WB 200 Physical diagnosis (General)
WB Practice of Medicine > Therapeutics > WB 330 Drug therapy
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.1 Diagnosis
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.2 Therapy
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.41 General coverage
Digital Object Identifer (DOI): https://doi.org/10.1097/01.aids.0000233575.26349.cc
Depositing User: Sarah Lewis-Newton
Date Deposited: 07 Mar 2011 16:09
Last Modified: 22 Jun 2018 09:21
URI: http://archive.lstmed.ac.uk/id/eprint/1588

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