Schreibman Tanya, Friedland Gerald
Yale University School of Medicine, AIDS Program, Yale-New Haven Hospital, New Haven, Connecticut 06510, USA.
Clin Infect Dis. 2004 Jan 15;38(2):257-62. doi: 10.1086/380792. Epub 2003 Dec 18.
The CD4 cell count has become a key laboratory measurement in the management of human immunodeficiency virus (HIV) disease. In ideal situations, HIV-infected persons are followed up longitudinally with serial CD4 cell counts to determine disease progression, risk for opportunistic infection, and the need for prophylactic or therapeutic intervention. However, the use of the CD4 cell count in resource-limited settings is often not possible because of lack of availability and high cost. Thus, other laboratory markers have been proposed as substitutes for the CD4 cell count. The data regarding the clinical utility of the total lymphocyte count (TLC) as a potential surrogate marker of immune function in patients with HIV disease are examined. The role of the TLC in the initiation of antiretroviral therapy and opportunistic infection prophylaxis, as well as the role of the TLC in monitoring the response to antiretroviral therapy, are also addressed.
CD4细胞计数已成为人类免疫缺陷病毒（HIV）疾病管理中的一项关键实验室检测指标。在理想情况下，对HIV感染者进行纵向随访，连续检测CD4细胞计数，以确定疾病进展、机会性感染风险以及预防性或治疗性干预的必要性。然而，由于资源有限地区缺乏检测条件且成本高昂，通常无法使用CD4细胞计数。因此，有人提出用其他实验室指标替代CD4细胞计数。本文探讨了关于总淋巴细胞计数（TLC）作为HIV疾病患者免疫功能潜在替代标志物的临床实用性的数据。还讨论了TLC在启动抗逆转录病毒治疗和预防机会性感染中的作用，以及TLC在监测抗逆转录病毒治疗反应中的作用。
