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treatment and CD4 %
Sep 6, 2006

I have been looking through published treatment guidelines and have been unable to find recommendations for starting treatment based on CD4% (as opposed to absolute CD4 count). I am curious about when treatment would be recommended based on a low CD4% with a normal CD4 count.

Thanks in advance for your response!

Response from Dr. Young

Thanks for your post.

You're correct insomuch as most treatment guidelines don't address the question about CD4 percentages and when to start medications. For reference, here's a link to the most recent (August 2006) IAS-USA guidelines.

If one makes the generalized assumption that on average, each absolute CD4 count of 100 is equivalent to a ~7.5 percentage points, then the typical person with an absolute count of 350 should have a CD4% of about 25-26.

In practical terms, I usually suggest that patients with absolute counts below 350 or percentages below 25 consider treatment. When counts are below 200 or 15%, then HAART should definitely be started (if possible).

I hope this helps. BY



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