ARUP's Laboratory Test Directory

0095853: Lymphocyte Subset Panel 3 - T-Cell Subsets (CD4 & CD8), Absolute Counts Only

[ image for: Time Sensitive]
Time Sensitive
  

Test Mnemonic: ABS
Methodology: Flow Cytometry

Performed: Sun-Sat

Reported: 1-3 days

Specimen Required:  
Collect: One 5 mL green Hemogard (sodium or lithium heparin) or one 5 mL lavender Hemogard (EDTA) or pink Hemogard (K2EDTA), labeled with the patient's name, date and time of draw.  (Min: 3 mL)  Pour-off tubes are no longer acceptable.

Transport: 5 mL whole blood at 20-25°C. (Min: 0.5 mL)

Submit specimen according to Biological Substance, Category B, shipping guidelines.

Pediatric Collection/Transport: 0.5 mL whole blood at 20-25°C. 

Submit specimen according to Biological Substance, Category B, shipping guidelines.

Remarks: CRITICAL AMBIENT. Only Hemogard tubes are acceptable.  Specimens must be analyzed within 48 hours of collection.  Some medications may affect immunophenotyping results and should be listed on the patient test request form.
This test is not approved for New York State clients.


Unacceptable Conditions: Clotted, hemolyzed, refrigerated, or frozen specimens. Specimens collected in pour-off tubes.  Specimens collected in ACD (yellow) tubes.  Specimens older than 48 hours.

Stability: Ambient: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable

Reference Interval:
 
Components Age: 0-11 months Age: 12-23 months Age: 2 years and older
Absolute CD4 (Helper T-cells) 1580-4850 1020-3600 370-1540
Absolute CD8 (Suppressor T-cells) 680-2470 570-2230 183-1160
Absolute CD3 (Total T-cells) 2170-6500 1460-5440 710-2300
CD4: CD8 ratio 1.17-6.62 1.17-6.62 0.80-5.00

Interpretive Data:
In this test, the CD4 cells are Helper T-cells because they express both CD3 and CD4. The CD8 cells are Suppressor T-cells because they express both CD3 and CD8. Helper T-cell levels are a criterion for categorizing HIV-related clinical conditions by the CDC's classification system for HIV infection. The measurement of Helper T-cell levels has been used to establish decision points for initiating P. jiroveci prophylaxis, antiviral therapy and to monitor the efficacy of treatment. The Public Health Service (PHS) has recommended that Helper T-cell levels be monitored every three to six months in all HIV-infected persons.

The performance characteristics of this test were determined by ARUP Laboratories, Inc.



Note:
This assay is designed for enumerating the absolute cell counts of lymphocyte subsets in lysed whole blood.  Whole blood is added to fluorochrome-labeled antibodies that bind specifically to cell surface antigens on lymphocytes.  After incubation, lysing and fixation, absolute counts are enumerated utilizing an internal quantitation standard.  Additional CBC data is not required.

During HIV infection, antiviral therapy is often initiated when the absolute CD4 count drops below 500 cells/µL. When the absolute CD4 count drops below 200 cells/µL, therapeutic prophylaxis against PCP and other opportunistic infections may be initiated. When the absolute CD4 count drops below 100 cells/µL, prophylaxis against Mycobacterium avium complex is recommended.

For longitudinal studies involving serial monitoring, specimen collections should be performed at the same time of day.

CPT Code(s):
86359 T-cell, total count; 86360 Absolute CD4 and CD8 count, including ratio

 

 

 
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