DIAGNOSING HIV-RELATED DISEASE - USING THE CD4 COUNT AS A GUIDE

OBJECTIVE: To summarize current information on the relation between CD 4 counts and the risk of different HIV-related diseases. MEASUREMENTS AND MAIN RESULTS: MEDLINE search of English language articles between 1985 and 1996 using the medical subject heading (MeSH) term ''CD4 lymp hocyte count'' and searches using key words of multiple HIV-related di seases were conducted. Some HIV-related diseases can be stratified to different CD4 count levels. Regardless of their CD4 count, HIV-infecte d patients are susceptible to sinusitis, Kaposi's sarcoma, community-a cquired pneumonia, and oral hairy leukoplakia. In advanced HIV, when C D4 is below 200/mm(3), Pneumocystis carinii pneumonia, toxoplasmosis, progressive multifocal leukoencephalopathy, Mycobacterium avium comple x, molluscum contagiosum, and bacillary angiomatosis all increase in i ncidence. In very advanced HIV disease, when CD4 counts are below 50/m m(3), patients are at risk of pseudomonas pneumonia, cytomegalovirus r etinitis, central nervous system lymphoma, aspergillosis, and dissemin ated histoplasmosis.