Opinion|Videos|May 16, 2025
CD4 T-cell and Lymphocyte Monitoring: Clinical Significance in HIV Treatment
Author(s)Sharon Walmsley, CM, MD, FRCPC
A panelist discusses how CD4 counts serve as measures of immune system status that typically increase by about 200 in the first year of antiretroviral therapy. Although there can be laboratory variability, these counts remain important for patient monitoring and identifying those at risk for complications.
Advertisement
CD4 T-Cell Monitoring in HIV Management
Key Themes:
- Immune Reconstitution: Average CD4 count increases of approximately 200 cells in the first year of effective therapy
- Laboratory Variability: CD4 count fluctuations of up to 20% between measurements, causing potential patient concern
- Clinical Utility Debate: Discussion of whether routine CD4 monitoring remains necessary in stable patients
- Toxicity Monitoring: Importance of CD4 count monitoring in trials of new agents with potential lymphotoxicity
Notable Insights from Dr Sharon Walmsley:
- Despite some recommendations to reduce CD4 monitoring (“choosing wisely” initiatives), many patients value these numbers as reinforcement that treatment is working.
- CD4 counts remain important for guiding opportunistic infection prophylaxis decisions in patients with lower values.
- CD4 monitoring can serve as a motivational tool for patients struggling with adherence.
- In switch studies, CD4 counts typically remain stable when patients are already virologically suppressed.
Advertisement
Related to this article
Initial frontal fibrosing alopecia treatment was largely similar in Black and White patients, though tetracycline use was higher in Black patients.
From taladegib to admilparant and inhaled treprostinil, here are the key 2026 advances in idiopathic pulmonary fibrosis care.
HHS does not intend to take enforcement action against pharmacies compounding BPC-157 and 5 other unapproved peptides if they meet 10 conditions.
Claims data show evidence of HIV virus in 5 of 2913 long-acting cabotegravir users and higher adherence vs oral therapy.
Real-world data show antifibrotic dose reductions in IPF were not significantly linked to faster disease progression vs staying on full dose.
Naim Alkhouri, MD, on real-world resmetirom results, when biopsy is still needed, choosing a GLP-1 or resmetirom, and access barriers in MASH
A post hoc ASPEN analysis links darker sputum to higher protease activity in bronchiectasis.
At an AJMC Stakeholder Interchange in Houston, leukemia specialists from academic centers and community practices said menin inhibitors work best in combination, warned that differentiation syndrome can strike months into therapy, and described payer rules that delay access even at flagship centers.
Advertisement
Advertisement
Trending on AJMC
1
HHS Draft Policy Eases Enforcement on 6 Compounded Peptides
2
Four Major Idiopathic Pulmonary Fibrosis Advances From 2026
3
5 Things to Know About HHS's Interim Peptide Compounding Policy
4
Experts Pitch National Risk Pool to Fund Gene Therapy Access
5