Laboratory Assays in the Clinical Management of Antiretroviral Therapy

  • Author: Mark Holodniy, MD (More Info)
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 12/12/17 (What's New)


  • Primary care physicians managing HIV-infected patients need to have a strong working knowledge of current guideline recommendations on appropriate laboratory testing before and during antiretroviral therapy
  • Although CD4+ T-lymphocyte cell count remains an essential laboratory test that assesses the patient’s immune status, monitors antiretroviral therapy effectiveness, and guides the need for initiation or discontinuation of opportunistic infection prophylaxis, current US HIV treatment guidelines recommend that all HIV-infected adults should be offered antiretroviral therapy regardless of CD4+ cell count[DHHS ART; IAS-USA ART]
  • CD4+ cell counts should be obtained every 3-6 months during the first 2 years of antiretroviral therapy. For patients who have experienced consistent virologic suppression for at least 2 years during antiretroviral therapy, CD4+ cell count should be assessed every 12 months while counts are between 300 and 500 cells/mm3 whereas monitoring is optional for patients with CD4+ cell counts > 500 cells/mm3[DHHS ART]

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