From the Guidelines
A normal CD4 count in healthy adults typically ranges from 500 to 1,600 cells per cubic millimeter (cells/mm³) of blood. This count represents the number of CD4+ T lymphocytes, which are white blood cells that play a crucial role in the immune system by coordinating immune responses against infections. CD4 counts are particularly important for monitoring immune function in people with HIV infection, where counts below 200 cells/mm³ indicate severe immunodeficiency and risk for opportunistic infections 1.
Key Points to Consider
- CD4 counts can vary slightly based on factors such as time of day, stress, and concurrent illnesses.
- For HIV patients, regular monitoring of CD4 counts helps healthcare providers assess disease progression and determine when to initiate or adjust antiretroviral therapy.
- Even within the normal range, what matters most is the stability of the count over time rather than a single measurement.
- The CD4 cell percentage can also be used to assess immune function and is somewhat less variable than the absolute count, with total CD4 cell counts of 200 and 500 cells/mm3 generally corresponding to CD4 cell percentages of 14% and 29%, respectively 1. If you're concerned about your CD4 count, it's essential to discuss the results with your healthcare provider, who can interpret them in the context of your overall health.
From the Research
Normal CD4 Count
The normal CD4 count can vary from person to person, but generally, a healthy individual has a CD4 count ranging from 500 to 1600 cells per cubic millimeter of blood [ 2 ].
Factors Affecting CD4 Count
Several factors can affect CD4 count, including:
- HIV infection: CD4 count is often used to monitor the progression of HIV infection and the effectiveness of antiretroviral therapy [ 3 ].
- Age: CD4 count can decrease with age [ 4 ].
- Health status: Certain medical conditions, such as cancer or autoimmune disorders, can affect CD4 count [ 5 ].
CD4 Count and Antiretroviral Therapy
Antiretroviral therapy (ART) is recommended for all adults with HIV infection, regardless of CD4 count [ 4 ]. The goal of ART is to suppress the virus and increase CD4 count.
- Initiating ART: The decision to start ART should be individualized based on the presence of comorbidities, risk factors for progression to AIDS and non-AIDS diseases, and patient readiness for treatment [ 3 ].
- Monitoring CD4 count: CD4 count should be monitored regularly to assess the effectiveness of ART and adjust treatment as needed [ 6 ].
Key Findings
Key findings from the studies include: