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Test Includes
Percentage CD4+; absolute CD4+; percentage CD8+; absolute CD8+; CD4:CD8 ratio; CBC with differential
Expected Turnaround Time
1 - 3 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Documents
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.
Stability Requirements
Temperature | Period |
|---|---|
Room temperature | Yellow-top (ACD-A) or (ACD-B) tube: 2 days Lavender-top (EDTA) tube: 1 day |
Refrigerated | Unstable |
Frozen | Unstable |
Freeze/thaw cycles | Unstable |
Causes for Rejection
Hemolysis; specimen refrigerated or frozen; clotted specimen; contaminated specimen
Test Details
Methodology
Flow cytometry
Reference Interval
Reference intervals for adults have been established by the laboratory. See table.
CD | 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. | |||||
CD4+ | 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 | |
CD8+ | Neonates | 10 | 41 | 200 | 1900 |
1 wk to 2 m | 9 | 23 | 400 | 1700 | |
2 to 5 m | 11 | 25 | 500 | 1600 | |
5 to 9 m | 13 | 26 | 600 | 2200 | |
9 to 15 m | 12 | 28 | 400 | 2100 | |
15 to 24 m | 11 | 32 | 400 | 2300 | |
2 to 5 y | 14 | 33 | 300 | 1600 | |
5 to 10 y | 19 | 34 | 300 | 1800 | |
10 to 16 y | 9 | 35 | 200 | 1200 | |
Adults | 12 | 36 | 109 | 897 | |
T4:T8 ratio | Adults | 0.92 | 3.72 | ||
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.
References
Centers for Disease Control and Prevention (CDC). 1997 revised guidelines for performing CD4+ T-cell determinations in persons infected with human immunodeficiency virus (HIV).MMWR. 1997 Jan 10; 46:RR-2.
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.
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 505010 | Absolute CD 4 Helper | /uL | 24467-3 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 505009 | % CD 4 Pos. Lymph. | % | 8123-2 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 505579 | Abs. CD 8 Suppressor | /uL | 14135-8 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 505580 | % CD 8 Pos. Lymph. | % | 8101-8 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 505273 | CD4/CD8 Ratio | 54218-3 | |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 005025 | WBC | x10E3/uL | 6690-2 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 005033 | RBC | x10E6/uL | 789-8 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 005041 | Hemoglobin | g/dL | 718-7 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 005058 | Hematocrit | % | 4544-3 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015065 | MCV | fL | 787-2 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015073 | MCH | pg | 785-6 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015081 | MCHC | g/dL | 786-4 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 105007 | RDW | % | 788-0 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015172 | Platelets | x10E3/uL | 777-3 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015107 | Neutrophils | % | 770-8 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015123 | Lymphs | % | 736-9 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015131 | Monocytes | % | 5905-5 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015149 | Eos | % | 713-8 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015156 | Basos | % | 706-2 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 115398 | Immature Cells | N/A | |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015909 | Neutrophils (Absolute) | x10E3/uL | 751-8 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015917 | Lymphs (Absolute) | x10E3/uL | 731-0 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015925 | Monocytes(Absolute) | x10E3/uL | 742-7 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015933 | Eos (Absolute) | x10E3/uL | 711-2 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015941 | Baso (Absolute) | x10E3/uL | 704-7 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015108 | Immature Granulocytes | % | 71695-1 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015911 | Immature Grans (Abs) | x10E3/uL | 53115-2 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015945 | NRBC | % | 58413-6 |
| 505271 | CD4/CD8 Ratio Profile | 65758-5 | 015180 | Hematology Comments: | 18314-5 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115400 | Bands | % | 35332-6 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115401 | Metamyelocytes | % | 28541-1 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115403 | Myelocytes | % | 26498-6 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115404 | Promyelocytes | % | 26498-6 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115405 | Blasts/blast like cells | % | 26498-6 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115406 | Megakaryocytes | % | 19252-6 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115265 | Other, Lineage Uncertain | % | 55433-7 |
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