This week PLOS Medicine publishes the following new articles:
Marc Lallemant and colleagues report that, for adults infected with HIV in Thailand, a monitoring strategy based on CD4 count (a type of white blood cell) provides a similar clinical outcome to the recommended viral load-based strategy (which measures the amount of HIV virus in a patient’s blood), when determining when to switch from first-line to more costly second-line antiretroviral treatment. The study provides reassurance for health centers in a resource-limited setting using CD4 counts alone to monitor treatment of patients with HIV.
David Hipgrave and colleagues argue that effective, equitable, feasible, and affordable ways to engage the public in health priority setting (HPS) in low- and middle-income countries remains elusive. Rather than mandating public participation in HPS, countries and donors should focus on building a policy environment that is conducive to grassroots initiatives and on strengthening the evidence for what works using small pilot studies.