What is the role of CD4 T-cell count in the risk assessment of opportunistic infection in HIV infection?

Updated: Jul 01, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The CD4 T-cell count reliably reflects the current risk of acquiring opportunistic infections, as follows:

  • Reference range, 500-2000 cells/μL

  • Because CD4 counts vary, serial counts are generally a better measure of significant changes

  • After seroconversion, CD4 counts tend to decrease (~700/μL) and continue to decline over time

  • For surveillance, a CD4 count below 200/μL is considered AIDS-defining in the United States

  • In children younger than 5 years, the CD4 T-cell percentage is considered more important than the absolute count (< 25% is considered to warrant therapy)

  • In adults with chronic hepatitis C and low absolute CD4 T-cells, the CD4 percentage may also be more useful [4]


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