In Nigeria, a multifaceted, integrated, tiered laboratory programme has been established by the Institute of Human Virology at the University of Maryland to support a PEPFAR-funded scale-up of AIDS care and treatment in 26 states.11 Services provided by the laboratory network include HIV rapid tests, adult CD4 counts, paediatric CD4 percentages, haematology, blood chemistries, syphilis serology, cryptococcal antigen test, TB smear microscopy, culture, drug susceptibility testing (DST), and molecular LPA. The gene discussed is CD4; the disease is syphilis.