Icon

Time Sensitive
Ordering Recommendation

Absolute CD4 count is sufficient for routine HIV monitoring.

Mnemonic
TSHORT
Methodology

Quantitative Flow Cytometry

Performed

Sun-Sat

Reported

1-2 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Collect

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

CRITICAL ROOM TEMPERATURE.

Unacceptable Conditions

BAL specimens (refer to ARUP test code 0093420). Clotted or hemolyzed specimens.

Remarks

Specimens must be analyzed within stability times provided. Some medication may affect immunophenotyping results and should be provided on the patient test request form.

Stability

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
Components 0-6 days 1 week-1 month 2-4 months 5-8 months 9-14 months 15-23 months 2-4 years 5-9 years 10-15 years 16-64 years 65 years or older
% CD3 38-88% 55-90 % 49-97 % 49-95% 56-87% 36-92% 52-92% 55-97% 52-90% 62-87% 62-89%
Absolute CD3 1400-6800 cells/µL 1900-8400 cells/µL 2200-9200 cells/µL 1400-11500 cells/µL 2400-8300 cells/µL 700-8800 cells/µL 850-4300 cells/µL 770-4000 cells/µL 850-3200 cells/µL 570-2400 cells/µL 660-2200 cells/µL
% CD4 26-62 % 39-69 % 37-69 % 27-81% 25-86% 16-91% 25-66% 26-61% 20-65% 32-64% 35-68%
Absolute CD4 1000-4800 cells/µL 1500-6000 cells/µL 1600-6500 cells/µL 1000-7200 cells/µL 1300-7100
cells/µL
400-7200 cells/µL 500-2700 cells/µL 400-2500 cells/µL 400-2100 cells/µL 430-1800 cells/µL 490-1600 cells/µL
% CD8 5-37% 7-35% 6-41% 10-35% 7-58% 7-40% 9-49% 13-47% 14-40% 15-46% 10-46%
Absolute CD8 200-2700 cells/µL 300-2700
cells/µL
300-3400 cells/µL 200-5400 cells/µL 400-4100 cells/µL 200-2800 cells/µL 200-1800 cells/µL 200-1700 cells/µL 300-1300 cells/µL 210-1200 cells/µL 150-1050 cells/µL
CD4:CD8 Ratio 1.00-2.6 1.30-6.30 1.70-3.90 1.60-3.80 1.30-3.90 0.90-3.70 0.90-2.90 0.90-2.60 0.90-3.40 0.80-3.90 0.80-6.17

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.

Compliance Category

Laboratory Developed Test (LDT)

Note

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
N/A
CPT Codes

86359; 86360

Components
Component Test Code* Component Chart Name LOINC
0095616 Lymphocyte Subset Panel 4 Information 48767-8
0095902 Absolute CD3 8122-4
0095903 % CD3 20599-7
0095906 Absolute CD4 24467-3
0095911 Absolute CD8 14135-8
2012857 % CD4 8123-2
2012858 % CD8 32518-3
2012860 CD4:CD8 Ratio 54218-3
* 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 click the sidebar link to access the Interface Map.
Aliases
  • CD3 and CD4
  • Helper T-cell count
  • Immune Status-Flow Cytometry
  • P. jiroveci prophylaxis determination
  • T-Cell Immunodeficiency Short Profile
  • T4/T8
Lymphocyte Subset Panel 4 - T-Cell Subsets Percent and Absolute, Whole Blood