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Clinical Versus Clinical Plus Laboratory Monitoring Of Aids


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There is a debate among the scientific and medical professionals whether clinical monitoring is inferior to clinical monitoring in conjunction with laboratory monitoring of patients diagnosed with AIDS and on antiretroviral medication. A study has recently been carried out in the Cameroon to determine whether clinical monitoring is in fact inferior to a combination of clinical and laboratory monitoring or not. The study found that the average CD4 T-cell count increased over the two-year period of the study.

The study that was done was a trial study, however, and not sufficient to draw any definitive conclusions. There were a number of limitations that the study faced, which will be detailed shortly, which prevent it from drawing any definitive conclusions. However, the study did seem to show that clinical monitoring of the effectiveness of an antiretroviral treatment programme was not inferior to a monitoring programme consisting of both clinical and laboratory monitoring.

The first weakness in the study is the fact that the sample size was small. A sample for any scientific study has to be representative of the population and of sufficient size. The size is determined by the nature of the study and the tests to be used in assessing the data gathered. It is possible that the sample size was limited by the number of willing participants available or by time or budgetary restrictions placed on the study.

The study also had a relatively short follow-up period. AIDS is a condition which can affect those infected with HIV for their entire lives. As such, a period of two years is a very short period of time as it does not allow for sufficient age and health variables to be taken into account. Once again, this may have been limited by budgetary restraints.

Since this was designed to be a trial study and was meant to determine the viability of a fully fledged study, these two weaknesses can be partially excused so long as no definitive conclusions are drawn from the study as it stands.

However, should it be decided that a more complete study be done on this particular topic there are a few things that should be modified to make the conclusions drawn from the full-sized study more viable. One is that the study should make use of the CD4 T-cell count to start the actual antiretroviral treatment in the group that is to use both clinical and laboratory monitoring. The study should also possibly look into the comparison of clinical to laboratory monitoring as they pertain to establishing an earlier diagnosis of therapeutic failure and a need for a change in antiretroviral treatment. It should also be ensured that the qualifications of the medical staff involved in the interpretation of the data from the laboratory tests are suitable to ensure that they are adequately qualified.

The results from this kind of study may be relevant for the Cameroon, which has good health services, however, they may not be generalised to other countries where health services are not as good. The study does seem to show potential benefits for people who have developed AIDS in terms of their antiretroviral treatment and its success.


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