Unit Code 82589:
T and B Quantitation, New York
Useful For
Monitoring CD4 counts and assessing immune deficiencies
Clinical Information
Normal immunity requires a balance between the activities of
various lymphocyte subpopulations with different effector and
regulatory functions.
Different immune cells can be characterized by unique surface
membrane antigens described by a cluster of differentiation
nomenclature (e.g., CD3 is an antigen found on the surface of
T-lymphocytes). Abnormalities in the number and percent of T
(CD3), T-helper (CD4), T-suppressor (CD8), B (CD19), and
Natural Killer (CD16 CD56) lymphocytes have been described
in a number of different diseases. In patients who are infected
with human immunodeficiency virus (HIV), the CD4 count is
measured for acquired immune deficiency syndrome (AIDS)
diagnosis and for initiation of antiviral therapy. The progressive loss
of CD4 T-lymphocytes inpatients infected with HIV is associated with
increased infections and complications.
The Public Health Service has recommended that all HIV-positive
patients be tested every 3-6 months for the level of CD4 T-lymphocytes.
Reference Values
T & B SURFACE MARKER
% T-cells (CD3)
0-2 months: 53-84%*
3-5 months: 51-77%*
6-11 months: 49-76%*
12-23 months: 53-75%*
2-5 years: 56-75%*
6-11 years: 60-76%*
12-17 years: 56-84%*
> or =18 years: 52-84%
B-cells (CD19)
0-2 months: 300-2,000 cells/uL*
3-5 months: 430-3,000 cells/uL*
6-11 months: 610-2,600 cells/uL*
12-23 months: 720-2,600 cells/uL*
2-5 years: 390-1,400 cells/uL*
6-11 years: 270-860 cells/uL*
12-17 years: 110-570 cells/uL*
> or =18 years: 71-567 cells/uL
Natural killer (CD16 CD56)
0-2 months: 170-1,100 cells/uL*
3-5 months: 170-830 cells/uL*
6-11 months: 160-950 cells/uL*
12-23 months: 180-920 cells/uL*
2-5 years: 130-720 cells/uL*
6-11 years: 100-480 cells/uL*
12-17 years: 70-480 cells/uL*
> or =18 years: 80-597 cells/uL
Helper cells (CD4)
0-2 months: 1,600-4,000 cells/uL*
3-5 months: 1,800-4,000 cells/uL*
6-11 months: 1,400-4,300 cells/uL*
12-23 months: 1,300-3,400 cells/uL*
2-5 years: 700-2,200 cells/uL*
6-11 years: 650-1,500 cells/uL*
12-17 years: 530-1,300 cells/uL*
> or =18 years: 401-1,532 cells/uL
Suppressor cells (CD8)
0-2 months: 560-1,700 cells/uL*
3-5 months: 590-1,600 cells/uL*
6-11 months: 500-1,700 cells/uL*
12-23 months: 620-2,000 cells/uL*
2-5 years: 490-1,300 cells/uL*
6-11 years: 370-1,100 cells/uL*
12-17 years: 330-920 cells/uL*
> or =18 years: 152-838 cells/uL
ABSOLUTE COUNTS
CD45 Lymph Count, Flow: 0.66-4.60 thou/uL
T-cells (CD3)
0-2 months: 2,500-5,500 cells/uL*
3-5 months: 2,500-5,600 cells/uL*
6-11 months: 1,900-5,900 cells/uL*
12-23 months: 2,100-6,200 cells/uL*
2-5 years: 1,400-3,700 cells/uL*
6-11 years: 1,200-2,600 cells/uL*
12-17 years: 1,000-2,200 cells/uL*
> or =18 years: 582-1,992 cells/uL
B-cells (CD19)
0-2 months: 300-2,000 cells/uL*
3-5 months: 430-3,000 cells/uL*
6-11 months: 610-2,600 cells/uL*
12-23 months: 720-2,600 cells/uL*
2-5 years: 390-1,400 cells/uL*
6-11 years: 270-860 cells/uL*
12-17 years: 110-570 cells/uL*
> or =18 years: 71-567 cells/uL
Natural killer (CD16 CD56)
0-2 months: 170-1,100 cells/uL*
3-5 months: 170-830 cells/uL*
6-11 months: 160-950 cells/uL*
12-23 months: 180-920 cells/uL*
2-5 years: 130-720 cells/uL*
6-11 years: 100-480 cells/uL*
12-17 years: 70-480 cells/uL*
> or =18 years: 80-597 cells/uL
Helper cells (CD4)
0-2 months: 1,600-4,000 cells/uL*
3-5 months: 1,800-4,000 cells/uL*
6-11 months: 1,400-4,300 cells/uL*
12-23 months: 1,300-3,400 cells/uL*
2-5 years: 700-2,200 cells/uL*
6-11 years: 650-1,500 cells/uL*
12-17 years: 530-1,300 cells/uL*
> or =18 years: 401-1,532 cells/uL
Suppressor cells (CD8)
0-2 months: 560-1,700 cells/uL*
3-5 months: 590-1,600 cells/uL*
6-11 months: 500-1,700 cells/uL*
12-23 months: 620-2,000 cells/uL*
2-5 years: 490-1,300 cells/uL*
6-11 years: 370-1,100 cells/uL*
12-17 years: 330-920 cells/uL*
> or =18 years: 152-838 cells/uL
LYMPHOCYTE RATIO
H/S ratio: > or = 1.0
*Shearer WT, Rosenblatt HM, Gelman RS, et al: Lymphocyte subsets
in healthy children from birth through 18 years of age: The Pediatric AIDS
Clinical Trials Group P1009 study. J Allergy Clin Immunol 2003;112(5):973-980
Interpretation
When the level falls below 500 cells/uL, HIV-positive patients can be
diagnosed with AIDS and can receive antiretroviral therapy. When
the CD4 count falls below 200 cells/uL, prophylaxis against
Pneumocystis jiroveci pneumonia is recommended.
Cautions
This assay is not used for diagnosing lymphocytic malignancies or
evaluation of lymphocytosis of unknown etiology. In these situations
Test #3287, "Leukemia Immunophenotyping by Flow Cytometry, Peripheral
Blood or Bone Marrow" which includes a hematopathology review.
Clinical Reference
1. Mandy F, Nicholson J, McDougal J: CBD: Guidelines for performing
single-platform absolute CD4 T-cell determinations with CD45
gating for persons infected with human immunodeficiency virus.
Center for Disease Control and Prevention. MMWR Morb Mortal
Wkly Rep 2003;52:1-13
2. Centers for Disease Control: 1997 Revised guidelines for performing
CD4 T-cell determinations in persons infected with human
immunodeficiency virus (HIV) MMWR 46 no RR-2: 1997, pp 1-29
3. U.S. Department of Health and Human Services: Recommendations
for prophylaxis against Pneumocitis carinii pneumonia for adults
and adolescents infected with human immunodeficiency virus.
MMWR 43 no. RR-3: 1994, pp 1-21
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