CD4 (Cluster of Differentiation 4)

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CD4 (cluster of differentiation 4) are white blood cells that play an important role in your immune system. A CD4 count helps indicate and provide a diagnosis of health conditions in your immune system; your body’s natural defences against pathogens, infections, and disease.

CD4 (cluster of differentiation 4) is a glycoprotein found on the surface of immune cells such as T-helper cells, monocytes, macrophages, and dendritic cells. CD4 is also referred to as helper cells as one of their main roles is to send signals to other viruses, including CD8 killer cells, which then destroy infectious particles. If a CD4 cell count is low, for example in untreated HIV infection, or prior to organ transplantation, your body becomes more susceptible to infections. 

The main problem of an HIV infection is the cells which are supposed to protect your immune system — become infected with the HIV virus. As a retrovirus, HIV needs to infect certain host cells to make its own copies. In this case, CD4 cells are the main target. 

Once infected, the HIV virus becomes attached to these CD4 cells then empty its genetic materials so that the host’s genetic code can be altered to produce other HIV virions. Thus, the infected CD4 cells are destroyed. The ability of the HIV-infected person to maintain his or her immune system gradually decreases — leaving them vulnerable to any infection. The HIV virus can evolve into worse infection and the CD8 T cells will eventually be unable to overcome the growing virus. 

Purposes of CD4 Test 

A CD4 test counts the levels of CD4 in your blood. A CD4 count refers to levels of blood cells in cubic millimetres of blood (a very small blood sample). A higher number indicates a stronger immune system. The CD4 count of a person who is not infected with HIV may range between 500 and 1500. Meanwhile, people who are infected with HIV with CD4 cell count above 500 are usually considered to have relatively good health.

HIV-infected persons with a CD4 count below 200 cells / mm 3 are at high risk of developing serious illness. Doctors may suggest HIV treatment for people with low CD4 count. 

Who Needs a CD4 Test ? 

When a person has been diagnosed with HIV, doctors may ask the patient to perform a CD4 test. The patient may be examined every few months to see if the CD4 count has changed since the first test. If the patient is being treated for HIV, the doctor may use a periodic CD4 cell count to see how well the medication is working.

The doctor will also ask the patient to do several other tests, such as:

  • Test showing CD4-CD8 Ratio. CD8 cells are types of white blood cells in the immune system. CD8 cells kill cancer cells and other infectious causes. This test compares the number of the two cells to obtain a more accurate analysis of the patient’s immune system function.
  • HIV Viral load test — this is a test that measures the amount of HIV in the blood.

Cost Estimation for CD4 Test

The cost for a CD4 test procedure may vary — depending on the hospital and clinic that provides the procedure. Each hospital and clinic usually offers a variety of service packages based on the patient’s diagnosis needs and financial ability.

For more details regarding the cost for a CD4 test procedure at home or abroad, contact Smarter Health.

Pre-CD4 Test 

In general, no special preparation is required for a CD4 test procedure. However, the patient still needs to handle the administrative arrangements. 

  • The patient needs to make an appointment with the doctor to perform the CD4 procedure. Then, followed by a consultation 
  • The patient should inform the doctor about any medication allergies
  • The patient should let the doctor know about any medicines he or she is taking — Inform either general or from doctor’s prescription / whether medical or herbal.
  • If the patient has previously been diagnosed with HIV, then he or she should let the doctor know about past treatment and medications
  • If the patient has previously done a CD4 test at a different hospital, then the patient needs to provide information on the test results and the time of the test to help the doctor identify the patient’s condition better

During CD4 Test 

A CD4 test is similar to any regular blood tests. A specialist doctor or nurse will draw blood from the patient’s vein, usually the elbow area or on the back of the hand.

First, the doctor will clean the puncture site with an antiseptic. Next, the doctor puts a ribbon or elastic band around the arm that blocks the blood flow — causing the patient’s blood vessels to protrude slightly. After that, a small needle will be inserted into the vein to collect the patient’s blood in a sterile bottle

Post- CD4 Test

After the doctor collects the patient’s blood sample, the elastic band around the arm will be removed and the patient will be asked to apply pressure to the puncture site with gauze. It is also possible to use a tape or a bandage to hold the gauze over the puncture site. The process usually takes less than five minutes.

Understanding Your CD4 Test Results

The CD4 result represents the number of cells per cubic millimeter of blood. The results may vary depending on the patient’s health and even the laboratory used for testing. If the patient has questions about the results, a consultation is recommended. The following is an overview of typical CD4 test results:

  • Normal: 500–1,200 cells per cubic millimeter
  • Abnormal: 250-500 cells per cubic millimeter. This means that the patient has a weakened immune system and may be infected with HIV.
  • Abnormal: 200 or fewer cells per cubic millimeter. This indicates the possibility of AIDS and a high risk of life-threatening infections. 

Although there is no cure for HIV, there are medications that can be used to protect the immune system and can prevent patients from developing AIDS. Today, people with HIV can live longer, with a better quality of life than ever before. If the patient has HIV, it is important to go to the healthcare provider, consult a doctor, and get tested regularly.

Side Effects of CD4 Test

Although this is a low-risk test, this test still has some of its own possible complications, such as: 

  • Headaches
  • Excessive bleeding.
  • Bruising or infection at the puncture site.

A CD4 test can help doctors analyze CD4 levels in a patient’s blood — which can be used to check the patient’s immune system condition. 

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