Pattern of infection in HIV and different CD4 counts
pattern of infection in HIV and different CD4 counts
The CD4 count is an indicator of the degree of immunosuppression in those infected with HIV.
- in healthy individuals the CD4 count is usually above 500 cells/µl (some may have naturally lower counts)
- in untreated HIV patients, the average rate of CD4 count decreases between 40-80 cells/µl per year (some may progress faster than others)
- a more rapid decline is likely to be present in patients who are not taking antiretroviral treatment and who have a high viral load
- patients with a CD4 count below 200 cells/µl are at most risk of HIV related problems (1)
Even at low CD4+ve lymphocyte levels, the T lymphocytes that remain still afford some protection against infection. This is manifest in a hierarchy of opportunistic pathogens, which begin to occur as the CD4+ve cell count declines.
CD4 counts and HIV related problems:
| risk of opportunistic infection | risk of HIV-associated | direct HIV |
500 and below | little risk |
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400 and below |
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350 and below |
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200 and below |
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100 and below |
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Reference:
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