Helper T-Lymphocyte Marker CD4

CPT: 86361
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Test Details

Synonyms

  • CD4+ Lymphocytes
  • T4 Helper Cells

Test Includes

Percentage of CD4+; absolute CD4+ (helper/inducer); absolute lymphocyte count; CBC

Use

Monitor patient's helper/inducer T-cell status

Methodology

Flow cytometry

Reference Interval

Reference intervals for adults have been established by the laboratory. See table.

CD4+ Reference Intervals for Lymphocyte Immunophenotyping

Age

95% Confidence Interval

Percentage

Cells/mm³

Minimum

Maximum

Minimum

Maximum

Pediatric reference intervals are from Comans-Bitter WM, de Groot R, van den Beemd R, et al. Immunophenotyping of blood lymphocytes in childhood. Reference values for lymphocyte subpopulations. J Pediatrics. 1997 Mar; 130(3):388-393.

Neonates

17

52

400

3500

1 wk to 2 m

41

68

1700

5300

2 to 5 m

33

58

1500

5000

5 to 9 m

33

58

1400

5100

9 to 15 m

31

54

1000

4600

15 to 24 m

25

50

900

5500

2 to 5 y

23

48

500

2400

5 to 10 y

27

53

300

2000

10 to 16 y

25

48

400

2100

Adults

31

59

359

1519

Additional Information

HIV-1 infection results in a decrease of CD4 T cells, an increase of CD8 T cells, a decrease in the CD4:CD8 ratio, and a progressive destruction of immune function. In HIV-1 seropositive patients, enumeration of CD4 T cells may be used for prognostic purposes and to monitor disease progression and antiretroviral therapy.

Specimen Requirements

Specimen

Whole blood

Volume

Fill tube(s) to capacity

Container

Lavender-top (EDTA) tube and yellow-top (ACD-A or ACD-B) tube

Collection

Invert tube 8 to 10 times immediately after collection. To preserve cellular viability, collect specimen so it will arrive in the laboratory within 48 hours of collection. Indicate date and time of venipuncture on the tube(s) and on the test request form.

Storage Instructions

Maintain specimen at room temperature. Do not freeze or refrigerate.

Stability Requirements

Temperature

Period

Room temperature

2 days

Refrigerated

Unstable

Frozen

Unstable

Freeze/thaw cycles

Unstable

Causes for Rejection

Hemolysis; specimen refrigerated or frozen; clotted specimen; contaminated specimen

Clinical Information

References

Giorgi J, Kesson A, Chou CC. Immunodeficiency and infectious diseases. In: Rose N, deMacario E, Fahey J, et al, eds. Manual of Clinical Laboratory Immunology. 4th ed. Washington, DC: ASM Press;1992:chap 25.
Stevens RA, Lempicki RA, Natarajan V, et al. General immunologic evaluation of patients with immunodeficiency virus infection. In: Detrick B, Hamilton RG, Folds JD, et al, eds. Manual of Molecular and Clinical Laboratory Immunology. 7th ed. Washington, DC: ASM Press;2006:chap 95.

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