Lymphocyte Subset Panel 4 - T-Cell Subsets Percent and Absolute, Whole Blood
Ordering Recommendation

Absolute CD4 count is sufficient for routine HIV monitoring.

Quantitative Flow Cytometry
1-2 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
Time SensitiveTime Sensitive
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Lavender (EDTA), pink (K2EDTA), or green (sodium or lithium heparin). Hemogard tubes are preferred for laboratory automation and safety. 
Specimen Preparation
Transport 4 mL whole blood. (Min: 0.5 mL) 
Storage/Transport Temperature
Unacceptable Conditions
BAL specimens (refer to ARUP test code 0093420). Clotted or hemolyzed specimens. 
Specimens must be analyzed within stability times provided. Some medication may affect immunophenotyping results and should be provided on the patient test request form. 
EDTA: Ambient: 72 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
Heparin: Ambient: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
New York State Clients: EDTA:
Ambient: 30 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
Heparin: Ambient: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable 
Reference Interval
Effective November 16, 2015

Reports include age appropriate reference intervals and interpretation.

Reference Interval Notes:
Pediatric reference values (0 - 6 days up to 10 - 15 years) taken from Scandinavian Journal of Immunology 2012; 75, 436-444.
Adult and Geriatric (16 - 64 and 65 plus years) ranges were developed in-lab.
Test Number
Components0-6 days1 week-1 month2-4 months5-8 months9-14 months15-23 months2-4 years5-9 years10-15 years16-64 years65 years or older
% CD338-88%55-90 %49-97 %49-95%56-87%36-92%52-92%55-97%52-90%62-87%62-89%
Absolute CD31400-6800 cells/µL1900-8400 cells/µL2200-9200 cells/µL1400-11500 cells/µL2400-8300 cells/µL700-8800 cells/µL850-4300 cells/µL770-4000 cells/µL850-3200 cells/µL570-2400 cells/µL660-2200 cells/µL
% CD426-62 %39-69 %37-69 %27-81%25-86%16-91%25-66%26-61%20-65%32-64%35-68%
Absolute CD41000-4800 cells/µL1500-6000 cells/µL1600-6500 cells/µL1000-7200 cells/µL1300-7100
400-7200 cells/µL500-2700 cells/µL400-2500 cells/µL400-2100 cells/µL430-1800 cells/µL490-1600 cells/µL
% CD85-37%7-35%6-41%10-35%7-58%7-40%9-49%13-47%14-40%15-46%10-46%
Absolute CD8200-2700 cells/µL300-2700
300-3400 cells/µL200-5400 cells/µL400-4100 cells/µL200-2800 cells/µL200-1800 cells/µL200-1700 cells/µL300-1300 cells/µL210-1200 cells/µL150-1050 cells/µL
CD4:CD8 Ratio1.00-2.61.30-6.301.70-3.901.60-3.801.30-3.900.90-3.700.90-2.900.90-2.600.90-3.400.80-3.900.80-6.17

Interpretive Data
The CD4 cells are Helper T-cells expressing both CD3 and CD4. The CD8 cells are Cytotoxic T-cells expressing both CD3 and CD8. CD3, CD4 and CD8 percentages are reported as a percent of total lymphocytes. CD4 T-cells levels are a criterion for categorizing HIV-related clinical conditions by CDC's classification system for HIV infection. The measurement of CD4 T-cell levels has been used to establish decision points for initiating P. jirovecii prophylaxis, antiviral therapy and to monitor the efficacy of treatment. The Public Health Service (PHS) has recommended that CD4 T-cell levels be monitored every 3 to 6 months in all HIV-infected persons.

Statement B: Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

This test is designed for enumerating the percents and absolute cell counts of lymphocyte subsets in lysed whole blood. Whole blood is added to fluorochrome-labeled antibodies that bind specifically to cell surface antigens on lymphocytes. After incubation, lysing and fixation, percents and absolute counts are enumerated utilizing an internal quantitation standard. Additional CBC data is not required.

During HIV infection, antiviral therapy is often initiated when the absolute CD4 count drops below 500 cells/µL. When the absolute CD4 count drops below 200 cells/µL, therapeutic prophylaxis against PCP and other opportunistic infections may be initiated. When the absolute CD4 count drops below 100 cells/µL, prophylaxis against Mycobacterium avium complex is recommended.

For longitudinal studies involving serial monitoring, specimen collections should be performed at the same time of day.
Hotline History
Component Test Code*Component Chart NameLOINC
0095616Lymphocyte Subset Panel 4 Information48767-8
0095902Absolute CD38122-4
0095903% CD320599-7
0095906Absolute CD424467-3
0095911Absolute CD814135-8
2012857% CD48123-2
2012858% CD832518-3
2012860CD4:CD8 Ratio54218-3
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please view this test within the Laboratory Test Directory found at
  • CD3 and CD4
  • Helper T-cell count
  • Immune Status-Flow Cytometry
  • P. jiroveci prophylaxis determination
  • T-Cell Immunodeficiency Short Profile
  • T4/T8