The 2014 recommendations of the International Antiviral Society – US Panel state that measurement of CD4 count is optional among patients with suppressed viral loads for >2 years and CD4 counts >500/µL. CD4 measurement in these patients is of low-value and may create unnecessary patient concern in response to normal variation of CD4 counts. In prospective studies of patients who have responded to antiretroviral therapy with HIV-1 RNA suppression and rises in CD4 cell count >200 cells/μL, there was little clinical benefit from continued routine measurement of CD4 counts.

Conditions: HIV, AIDS

Diagnostic Tests: CD4 count

Treatments: HIV-1 RNA suppression, antiretroviral therapy

Sources

• Gale HB, Gitterman SR, Hoffman HJ, et al. Is frequent CD4+ T-lymphocyte count monitoring necessary for persons with counts >=300 cells/μL and HIV-1 suppression? Clin Infect Dis. 2013 May;56(9):1340-3. (PubMed)
• Günthard HF, Aberg JA, Eron JJ, et al. Antiretroviral treatment of adult HIV infection: 2014 recommendations of the International Antiviral Society-USA Panel. JAMA. 2014 Jul 23-30;312(4):410-25. (PubMed)
• Sax PE. Editorial commentary: can we break the habit of routine CD4 monitoring in HIV care? Clin Infect Dis. 2013 May;56(9):1344-6. (PubMed)