Lymphocyte Subset Panel 2 - CD4 Percent and Absolute
0095885
Ordering Recommendation
 
Mnemonic
CD4
Methodology
Quantitative Flow Cytometry
Performed
Sun-Sat
Reported
1-2 days  
New York DOH Approval Status
Specimens from New York clients will be sent out to a New York DOH approved laboratory, if possible.
Submit With Order
Time SensitiveTime Sensitive

Specimen Required
Patient Preparation
  
Collect
Lavender Hemogard (EDTA), pink Hemogard (K2EDTA), or green Hemogard (sodium or lithium heparin). Hemogard tubes are preferred for laboratory safety.  
Specimen Preparation
Transport 4 mL whole blood. (Min: 0.5 mL)  
Storage/Transport Temperature
CRITICAL ROOM TEMPERATURE.  
Unacceptable Conditions
Frozen or refrigerated specimens. Specimens older than 72 hours in EDTA or 48 hours in heparin. Clotted or hemolyzed specimens.  
Remarks
Specimens must be analyzed within 72 hours of collection in EDTA or within 48 hours of collection in heparin. Some medications may affect immunophenotyping results and should be listed on the patient test request form.
This test is not approved for New York State Clients.
 
Stability
Ambient: 72 hours in EDTA, 48 hours in heparin; Refrigerated: Unacceptable; Frozen: Unacceptable  
Reference Interval
Effective November 18, 2013
 
Components Age: 0-​11 months Age: 12-​23 months Age: 2 years and older
%CD4 (Helper T-​cells) 38-​62 % 31-​54 % 32-​64 %
Absolute CD4 (Helper T-​cells) 1580-​4850 cells/µL 1020-​3600 cells/µL 430-​1800 cells/µL
Interpretive Data
The CD4 cells are Helper T-cells expressing both CD3 and CD4. CD4 T-cell levels are a criterion for categorizing HIV-related clinical conditions by the CDC's classification system for HIV infection. The measurement of CD4 T-cell levels has been used to establish decision points for initiating P. jiroveci 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 three to six months in all HIV-infected persons.

See Compliance Statement B: www.aruplab.com/CS  
Note
This test is designed for enumerating the percents and absolute cell counts of CD4 Helper T-cells 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.
CPT Code(s)
86361
Components
Component Test Code*Component Chart Name
0095621Lymphocyte Subset Panel 2 Information
0095905% CD4
0095906Absolute CD4
* 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 click the sidebar link to access the Interface Map.
Aliases
  • CD4
  • CD4 and absoute Count
  • Helper T-Cell level
  • Immune Status-Flow Cytometry
  • P. jiroveci prophylaxis determination