II. Indication

  1. Detecting HIV related Immune Deficiency (most accurate measure)
  2. Monitoring HIV Disease
  3. Used in combination with Plasma Viral Load Testing

III. Efficacy

  1. Advantages
    1. Best marker of of Immune SystemImpairment
    2. Roughly correlated to duration and activity of HIV Infection
    3. Best predicts prognosis
  2. CD4 Cell Counts have variability
    1. Vary from person to person even given the same HIV severity
    2. Vary widely from lab to lab
      1. Use the same lab to follow patients
    3. Diurnal CD4 Cell Count variation (from 50-150 cells/mcl)
    4. CD4 Count may drop 50% with acute comorbid illness (e.g. Influenza, Pyelonephritis)

IV. Labs: Normal

  1. Non-HIV patients: 800-1200 cells/mcl

V. Labs: Interpretation

  1. See HIV Course
  2. Each CD4 Count 10% rise decreases progression risk 15%
  3. Stage 1: CD4 500 Cells/mm3 or more
  4. Stage 2: CD4 200 to 499 Cells/mm3
  5. Stage 3: CD4 <200 Cells/mm3 or AIDS-Defining Illness

VI. Labs: Surrogates for CD4 Count

  1. Patient medical records and CD4 Count may be unavailable to emergency providers
  2. Surrogates for low CD4 Counts <200 Cells/mm3
    1. Absolute Lymphocyte Count (ALC) <1000 to 1250 cells/mm3
      1. See Absolute Lymphocyte Count Estimation of CD4 Count
    2. Prophylactic Antibiotic daily use found on medication reconciliation
      1. Trimethoprim-Sulfamethoxazole
      2. Dapsone
      3. Pentamidine
      4. Azithromycin
      5. Fluconazole

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Related Studies

Ontology: CD4 Count determination procedure (C0243009)

Definition (MSH) The number of CD4-POSITIVE T-LYMPHOCYTES per unit volume of BLOOD. Determination requires the use of a fluorescence-activated flow cytometer.
Concepts Laboratory Procedure (T059)
MSH D018791
English CD4 Cell Count, CD4 Cell Counts, CD4 Count, CD4 Counts, CD4 Lymphocyte Count, CD4 Lymphocyte Counts, CD4+ Cell Count, CD4+ Cell Counts, CD4+ Count, CD4+ Counts, Count, T4 Lymphocyte, Counts, T4 Lymphocyte, Lymphocyte Count, CD4, Lymphocyte Count, T4, Lymphocyte Counts, CD4, Lymphocyte Counts, T4, T4 Lymphocyte Count, T4 Lymphocyte Counts, LYMPHOCYTE COUNT CD 004, CD 004 LYMPHOCYTE COUNT, LYMPHOCYTE COUNT T 004, cd4 cell count, cd4 counts, cd4 count, CD4 Count determination procedure
Swedish CD4-lymfocytantal
Czech CD4 lymfocyty - počet
Finnish CD4-lymfosyyttimäärä
French Numération lymphocytaire T CD4+, Numération des lymphocytes T4, Numération lymphocytaire CD4, Numération des lymphocytes CD4, Numération des lymphocytes CD4+, Numération des lymphocytes T CD4, Numération lymphocytaire T CD4, Taux de lymphocytes T CD4+, Taux de lymphocytes T4, Taux de lymphocytes CD4, Numération des lymphocytes T CD4+, Taux de lymphocytes CD4+, Taux de lymphocytes T CD4, Numération lymphocytaire CD4+, Numération lymphocytaire T4
Russian LIMFOTSITOV CD4 PODSCHET, CD4 LIMFOTSITOV KOLICHESTVA OPREDELENIE, T4 LIMFOTSITOV PODSCHET, CD4 ЛИМФОЦИТОВ КОЛИЧЕСТВА ОПРЕДЕЛЕНИЕ, T4 ЛИМФОЦИТОВ ПОДСЧЕТ, ЛИМФОЦИТОВ CD4 ПОДСЧЕТ
Japanese CD4リンパ球計数, T4リンパ球計数, CD4リンパ球数, T4リンパ球計算, リンパ球計数-CD4
Italian Conta delle cellule CD4+, Conta CD4, Conta dei linfociti CD4, Conta dei linfociti T4, Conta CD4+, Conta delle cellule CD4, Conta dei linfociti CD4 positivi
German LYMPHOZYTENZÄHLUNG CD 004, CD 004 LYMPHOZYTENZÄHLUNG, LYMPHOZYTENZÄHLUNG T 004, CD4-Lymphozytenzählung, Lymphozytenzählung, CD4-, T4-Lymphozytenzählung
Polish Liczba limfocytów CD4, Liczba komórek CD4, Liczba CD4+, Liczba komórek CD4+
Norwegian CD4-lymfocyttantall, CD4-celletelling, CD4-telling, T4 lymfocytt-telling, CD4-lymfocytt-telling, T4 lymfocyttelling, CD4-lymfocyttelling
Dutch CD4-lymfocytentelling, T4-lymfocytentelling, Telling, CD4-lymfocyten-
Portuguese Contagem de Linfócito CD4, Contagem de Linfócito T4
Spanish Recuento de Linfocito CD4, Recuento de Linfocito T4