One of the critical aspects of medical practice and the medicinal process is the ability to analyze lab tests and derive diagnostic conclusions. The relationship between levels of CD4 lymphocytes and the likelihood of clinical complications from acquired immunodeficiency syndrome (AIDS) is positive. It is stated that “the CD4 count normal range is 500 to 1500 cell/mm^3. If a patient is left untreated, levels can drop below 200 cells/mm^3, which is one indication for the diagnosis of AIDS” (Garcia & Guzman, 2021, para. 8). The laboratory test results show that the total CD4 count for the patient is 280, which is below the normal range (Pagana & Pagana, 2017). It should be noted that “CD4 T lymphocytes are a part of the human T-lymphocyte cells that are produced in the bone marrow and eventually mature in the thymus” (Garcia & Guzman, 2021, para. 1). CD4 lymphocytes play a vital role in combatting the spread, effects, and damage caused by the human immunodeficiency virus (HIV). Low levels of CD4 are indicative of severely weakened immune system mechanisms, which are necessary to protect the body from infectious viral growth.
The United States Public Health Service recommends monitoring CD4 counts every 3–6 months in patients infected with HIV due to the treatment effect of the antiretroviral therapy (ART) response time. Firstly, it is stated that “For patients beginning ART, CD4 count should be repeated every three months for the first two years of suppressive ART for those with CD4 counts <300 cells/mm3” (National Institutes of Health’s Office of AIDS Research, 2022, para. 17). However, such as CD4 lymphocyte measurement can be conducted every six months if the value of the CD4 count is greater than or equal to 300 cells/mm3 (National Institutes of Health’s Office of AIDS Research, 2022, para. 17). In addition, “after two years of suppressive ART, CD4 count monitoring can be reduced to every six months for patients whose CD4 counts remain at <300 cells/mm3” (National Institutes of Health’s Office of AIDS Research, 2022, para. 17). The patients whose count improves over the latter number can proceed with annual measurements and testing after two years of the treatment.
Since the patient is likely to be unaware of his diagnosis of HIV/AIDS, it is important to approach him with a consideration of four practices. Firstly, a professional medical needs to demonstrate interest when it comes to addressing various barriers to care (Centers for Disease Control and Prevention, 2019). Secondly, it is essential to ensure collaborative decision-making and open communication. Thirdly, it is mandatory to focus on fostering patient trust (Centers for Disease Control and Prevention, 2019). Fourthly, a professional medical needs to assist the patient in modifying his behaviors to a path of better retention and adherence to HIV care.
HIV/AIDS is a reportable disease in Florida, and a medical professional is required to report it. This can be done in two main ways: to call (813) 307-8011 (Florida Department of Health, 2020). The second method is to mail “a completed case report form to Florida Department of Health – Hillsborough County Attn: Surveillance, Annex, 2nd Floor P.O. Box 5135 Tampa, Florida 33675-5135” (Florida Department of Health, 2020, para. 1). A failure to report can lead to disciplinary actions and fines. Thus, the first case provided insightful information about the importance of tracking CD4 lymphocyte levels as a strong indicator of HIV/AIDS progression.
References
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Centers for Disease Control and Prevention. (2019). Talking to your patients. Web.
Florida Department of Health. (2020). How to report (HIV/AIDS). Web.
Garcia, S. A. B., & Guzman, N. (2021). Acquired immune deficiency syndrome CD4+ count. In StatPearls [Internet]. StatPearls Publishing.
National Health Service. (2019). Overview: Vitamin B12 or folate deficiency anemias. Web.
National Institutes of Health’s Office of AIDS Research. (2022). Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Web.
Pagana, K. D., & Pagana, T. J. (2017). Mosby’s manual of Diagnostic and laboratory tests (6th ed.). Mosby Elsevier.
Perera, C. A., Biggers, R. P., & Robertson, A. (2019). Deceitful red flag: Angina secondary to iron deficiency anemia as a presenting complaint for underlying malignancy. BMJ Case Reports, 12(7), e229942.