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 June 14, 2003
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CD4 Lymphocyte Monitoring
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Monitoring lymphocyte counts in a patient with HIV infection is one way to assess the degree of immunosuppression and the risk of developing opportunistic infections. For several years after exposure to human immunodeficiency virus (HIV), an infected person will typically have either no symptoms or only minor ones such as chronically swollen lymph nodes. However, despite the absence of noticeable symptoms, HIV may be silently causing damage. HIV infects and kills certain white blood cells called CD4 lymphocytes, reducing their number. The number of CD4 cells usually declines over time in an HIV-infected person. CD4 lymphocytes act as the 'on switch' for part of the immune system, so as the number of CD4 cells drops, damage to the immune system may progress. Over time, individuals become increasingly susceptible to infections caused by organisms that are usually controlled by people with adequate immune systems. Those infections are called opportunistic infections. Years after infection, HIV-infected people may develop symptoms such as night sweats, chronic diarrhea, fatigue, fever, and various skin problems. These symptoms vary in severity for each individual. If the individual receives no treatment and further immune impairment occurs, the body becomes susceptible to life-threatening complications.


What is the CD4 count? Has the count dropped since it was last taken? How accurate is the count? At what level should treatment begin? How can the symptoms be controlled? What preventive measures should be taken? When should the count be repeated? Is HIV counseling available?

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