How do you use CD4% in clinical practice in management of patients living with HIV?
Answer from: at Academic Institution
Perhaps a slightly different perspective: The CD4 percentage is invaluable in specific scenarios.
Since the absolute CD4 count depends on the total WBC count and the lymphocyte percentage, the CD4 count can vary widely based on context, while the CD4 percentage is typically the more stable and reli...
I often use the CD4% to follow trends over time, particularly if there is an abrupt drop in the absolute CD4 (e.g., in acute illness). It can be informative for us as well as for consulting teams and the patients to see that the marker of immune function is actually stable when the absolute CD4 look...
This always confused us AIDS doctors a little, since "The measurement of absolute CD4+ T-cell levels in whole blood is the product of three laboratory techniques: the white blood cell (WBC) count; the percentage of WBCs that are lymphocytes (differential); and the percentage of lymphocytes that are ...
Hi - although the clinical lab may provide the %CD4, the much more important number is the actual CD4 T cell count, which should be checked at least once a year, if not more often if ART was just initiated and the CD4 count is very low. Of course, one should make sure that the patient is not also in...
In the face of acute illnesses especially viral infections, the absolute CD4 count can decrease as eloquently discussed above. I use the CD4% to provide reassurance to patients that their immune systems are intact.
All of the above explanations confirm this practice.
There is no single answer to this question.
For longitudinal trend, CD4% is a better indicator to avoid transient fluctuations due to an acute illness or stress, etc. This is especially useful when the total lymphocytes and CD4 counts are low secondary to an acute viral illness or drug side effects...
Total CD4, it is. Yes, we record the percentage as well, but it's prone to error due to other cell populations (e.g., CD8 T-cell) changing in HIV. The correlations with OI risks have been made with total CD4. The ratio (CD4/CD8 trend over time is useful to look at as well regarding immune control, b...