CD4 and tuberculosis: Four trials, Rosen et al, Koenig et al, Stevens et al and Rosen et al, newly introduced SDI in a clinical standard of care in which SDI was previously not routinely implemented.9 11 12 31 Standard ART initiation practices included rigid requirements to complete baseline diagnostics (CD4 cell count, TB diagnostics, etc.)and adherence counselling sessions prior to ART initiation.