Medical Minute: Estimating CD4 count in HIV positive patients

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November 18, 2014 by dailybolusoflr

By Ryan Circh, MD
  • Normal CD4 count in non-HIV infected patient: 800-1000
  • CD4 count less than 200 is highly predictive of increased susceptibility to opportunistic infection
  • Absolute lymphocyte count (ALC) = WBC count times lymphocyte percentage
  • ALC less than 1000 correlated with CD4 less than 200 with high specificity (96%)
  • ALC greater than 2000 correlated with CD4 greater than 200 with high sensitivity (97%)
  • ALC in between had tendency towards greater than 200, but still indeterminate

Shapiro et al. Absolute Lymphocyte Count as a Predictor of CD4 Count. Annals of EM, 1998;32:323-328. 

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