Diagnosing HIV-related disease: using the CD4 count as a guide

J Gen Intern Med. 1998 Feb;13(2):131-6. doi: 10.1046/j.1525-1497.1998.00031.x.


Objective: To summarize current information on the relation between CD4 counts and the risk of different HIV-related diseases.

Measurements and main results: MEDLINE search of English language articles between 1985 and 1996 using the medical subject heading (MeSH) term "CD4 lymphocyte count" and searches using key words of multiple HIV-related diseases were conducted. Some HIV-related diseases can be stratified to different CD4 count levels. Regardless of their CD4 count, HIV-infected patients are susceptible to sinusitis, Kaposi's sarcoma, community-acquired pneumonia, and oral hairy leukoplakia. In advanced HIV, when CD4 is below 200/mm3, Pneumocystis carinii pneumonia, toxoplasmosis, progressive multifocal leukoencephalopathy, Mycobacterium avium complex, molluscum contagiosum, and bacillary angiomatosis all increase in incidence. In very advanced HIV disease, when CD4 counts are below 50/mm3, patients are at risk of pseudomonas pneumonia, cytomegalovirus retinitis, central nervous system lymphoma, aspergillosis, and disseminated histoplasmosis.

Publication types

  • Review

MeSH terms

  • AIDS-Related Opportunistic Infections / immunology*
  • CD4 Lymphocyte Count*
  • Central Nervous System Diseases / immunology
  • HIV Infections / immunology*
  • Humans
  • Pneumonia, Bacterial / immunology
  • Sinusitis / immunology
  • Skin Diseases, Infectious / immunology
  • Tuberculosis / immunology