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Change in CDC guidelines about frequency of CD4 test for people with stable CD4 levels??

Feb 20, 2011

Yesterday at my quarterly meeting with my doctor to discuss my latest bloodwork, he told me that a couple of months ago the CDC had changed its guidelines regarding how frequently people with stable CD4 levels ought to have their CD4 levels measured. Now, apparently, they recommend this test only every six months rather than every three months. Is this correct?

My own CD4 count has indeed been stable for some years at roughly 490; the doctor showed me a graph which was almost a straight line. So it's not that I don't understand that the level has been stable: in other ways my health is very good, and HIV well controlled for over 15 years. It's just that this will be the first time in over 20 years that my levels haven't been checked quarterly, which makes me slightly anxious. It feels odd to break the "ritual."

I am curious to hear the CDC's thinking in changing this guideline--is it just to save money on unnecessary tests? How long do they recommend that a person's CD4 level be stable before moving to testing every six months?

Response from Dr. Holodniy

Yes, the new national guidelines issued last month indicate that in those people who have had stable HIV infection for some time, CD4 counts can now be monitored every 6-12 months. This is on a case by case basis and is based on a long term pattern such as yours. The punted on how long that pattern needs to be, but sounds like you make the cut. I have enclosed the URL for the new guidelines for your reference.

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