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CD4 T-cell and Lymphocyte Monitoring: Clinical Significance in HIV Treatment
A panelist discusses how CD4 counts serve as measures of immune system status that typically increase by about 200 in the first year of antiretroviral therapy. Although there can be laboratory variability, these counts remain important for patient monitoring and identifying those at risk for complications.
EP: 1.HIV Viral Suppression: Clinical Significance and Impact on Patient Outcomes
EP: 2.Changing Patient Demographics in HIV and Impacts of Polypharmacy on Treatment
EP: 3.Phase 3 HIV Treatment Switch Studies: Key Findings From Recent Clinical Trials
EP: 4.HIV Therapy Without Integrase Inhibitor: Practical Advantages and Targeted Patient Populations
EP: 5.Long-Acting HIV Therapies: Real-World Data and Clinical Application
EP: 6.CD4 T-cell and Lymphocyte Monitoring: Clinical Significance in HIV Treatment
EP: 7.CROI 2025 Insights: Evolving HIV Treatment Landscape and Practice-Changing Developments
CD4 T-Cell Monitoring in HIV Management
Key Themes:
- Immune Reconstitution: Average CD4 count increases of approximately 200 cells in the first year of effective therapy
- Laboratory Variability: CD4 count fluctuations of up to 20% between measurements, causing potential patient concern
- Clinical Utility Debate: Discussion of whether routine CD4 monitoring remains necessary in stable patients
- Toxicity Monitoring: Importance of CD4 count monitoring in trials of new agents with potential lymphotoxicity
Notable Insights from Dr Sharon Walmsley:
- Despite some recommendations to reduce CD4 monitoring (“choosing wisely” initiatives), many patients value these numbers as reinforcement that treatment is working.
- CD4 counts remain important for guiding opportunistic infection prophylaxis decisions in patients with lower values.
- CD4 monitoring can serve as a motivational tool for patients struggling with adherence.
- In switch studies, CD4 counts typically remain stable when patients are already virologically suppressed.
Integrated Care for Chronic Conditions: A Randomized Care Management Trial
December 3rd 2025The authors sought to understand the differential impact of payer-led community-based care management approaches on stakeholder-oriented outcomes for publicly insured adults with multiple chronic conditions.
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Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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