The association of clinical conditions and serologic tests with CD4+ lymphocyte counts in HIV-infected subjects without AIDS

Early intervention guidelines in HIV infection require knowledge of CD4+ lymphocyte count; however, CD4+ determinations require special laboratory procedures and may not be readily available in all situations. Using data from 207 HIV-seropositive homosexual men without AIDS, we evaluated the association of difference clinical conditions or serologic tests with CD4+ count. Men with conditions including seborrheic dermatitis, hairy leukoplakia, oral candidiasis and chronic diarrhea, and men with beta₂-microglobulin levels ≥4.0mg/l had significantly lower CD4+ counts. However, the probability that a subject with such parameters had <200 × 10⁶/l CD4+ cells was limited (25-63%). Although the probability that a subject with such parameters had <500 × 10⁶/l CD4+ cells was better (76-88%), the probability that a person without these parameters had ≥500 × 10⁶/l CD4+ cells was only 45-50%. Clinical and serologic parameters may provide important prognostic information, but cannot be used to reliably determine the level of CD4+ cells.