|
|
| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
Lymphocyte Subset Panel 5
Test Code8360
CPT Codes
86361<br>This test is for non-New York patient testing. For New York patient testing use test code 17332
Includes
% CD4, Absolute CD4+ Cells, Absolute Lymphocytes
Preferred Specimen
5 mL whole blood collected in an EDTA (lavender-top) tube
Minimum Volume
0.5 mL
Instructions
Maintain the specimen at ambient temperature. Do not refrigerate. It is recommended that the sample be drawn shortly before courier pick up and be received within 24 hours.
Transport Temperature
Room temperature
Specimen Stability
Room temperature: 72 hours
Refrigerated: Unacceptable
Frozen: Unacceptable
Refrigerated: Unacceptable
Frozen: Unacceptable
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolysis • Lithium heparin (green-top) tube • ACD (yellow-top) tube • Clotted
Methodology
Flow Cytometry (FC)
Setup Schedule
Set up: Daily; Report available: 2-3 days
Reference Range
See Laboratory Report
Clinical Significance
This panel is used to measure CD4+ T cells (CD4) in the blood (absolute CD4 cell count, %CD4, absolute lymphocytes). The CD4+ T-cell (CD4) count is the most valuable indicator of immune status in HIV-infected individuals. This panel can be used to establish a baseline CD4 level and to monitor treatment progress. It can also be used to facilitate differential diagnoses between congenital and acquired immunodeficiency diseases [1].
A significant reduction in CD4 count can lead to opportunistic infections, and the CD4 cell count/percentage can he used to make decisions regarding opportunistic infection prophylaxis as per guidelines [1].
During the first 2 years of antiretroviral (ARV) therapy, CD4 levels should be tested every 3 to 6 months. Patients who develop viremia while on therapy or whose CD4 count stays below 300 cells/µL should also have their CD4 levels tested every 3 to 6 months. After 2 years of ARV therapy, with consistently suppressed viral load and a CD4 count of 300 to 500 cells/µL, CD4 counts should be tested every 12 months. Note that when CD4 counts are > 500 cells/ µL, CD4 testing is optional [1]. CD4 testing should also be conducted if therapy fails. Refer to current HIV management guidelines for further information on recommended testing frequency [1].
Reference
1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. https://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf. Updated July 10, 2019. Accessed November 10, 2019.
A significant reduction in CD4 count can lead to opportunistic infections, and the CD4 cell count/percentage can he used to make decisions regarding opportunistic infection prophylaxis as per guidelines [1].
During the first 2 years of antiretroviral (ARV) therapy, CD4 levels should be tested every 3 to 6 months. Patients who develop viremia while on therapy or whose CD4 count stays below 300 cells/µL should also have their CD4 levels tested every 3 to 6 months. After 2 years of ARV therapy, with consistently suppressed viral load and a CD4 count of 300 to 500 cells/µL, CD4 counts should be tested every 12 months. Note that when CD4 counts are > 500 cells/ µL, CD4 testing is optional [1]. CD4 testing should also be conducted if therapy fails. Refer to current HIV management guidelines for further information on recommended testing frequency [1].
Reference
1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. https://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf. Updated July 10, 2019. Accessed November 10, 2019.
