When is CD4 count indicated in the management of HIV infection in primary care?

Updated: Apr 09, 2019
  • Author: Jason F Okulicz, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Answer

This is important for HIV staging and prognosis. It helps guide initiation of ART and indicates risk of opportunistic infections and guides initiation of prophylaxis.

DHHS guidelines [3] recommend checking the CD4 count upon entry into care and repeating every 3-6 months in patients who have not initiated ART. In patients on ART, CD4 count monitoring should also be performed every 3-6 months during the first 2 years of ART or if viremia develops while the patient is on ART.

After 2 years on ART with consistently suppressed viral load, the CD4 count can be tested every 12 months in those with a CD4 count between 300 and 500 cells/µL; CD4 count monitoring is optional in those with CD4 count over 500 cells/µL.


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