IMPROVED AIDS SURVEILLANCE THROUGH LABORATORY-INITIATED CD4 CELL COUNT REPORTING

Objective: To evaluate laboratory-initiated CD4 reporting (LICR) for B IDS surveillance and for differences in cases found by LICR and tradit ional surveillance methods (i.e., health care provider or death certif icate reports and medical record searches). Methods: We compared the c haracteristics of persons reported with AIDS between May 1993 and Apri l 1994 by traditional methods or by LICR reports <200/mu l. Results: W e received 643 LICR reports and 278 AIDS case reports. HIV status was available on 94% of LICR reports; 96% of these persons were HIV-infect ed. LICR reports mere received on 250 (90%) AIDS cases. Cases found by LICR were less likely to be persons of color and to have opportunisti c illnesses and more likely to live in rural areas. Cost of LICR to th e health department was less than the salary of one research analyst. Conclusions: LICR, with a high positive predictive value, is a highly sensitive, timely, and relatively inexpensive method of surveillance a nd its use should be considered in other jurisdictions.