CD4 count to no longer be drawn with quarterly labs

Sep 14, 2013

I recently read that the CD4 count will soon no longer be measured during quarterly labs. All along we have been told that the CD4 along with the viral load are a combined indicator of how well one is responding to ART. Why the sudden shift? Was the CD4 not necessary all along and this was a way for big-med do make money? What is really the best indicator of one's HIV health? (I believe the NEJM has poo-pooed the need for CD4 counts and the CDC is recommending skipping the CD4 lab work.)

Response from Dr. Holodniy

The devil is in the details regarding statements like these, and it is unlikely that one size fits all. There are certainly situations, for example, where people with CD4 counts in the normal range, and who have been stable on HIV treatment for years, probably don't need to have their CD4 count checked quarterly and once yearly might be appropriate. There is also a contrarian view, particularly in developing countries and with published data, that viral load testing is not necessary and just follow the CD4 count/percent.