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Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

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Item Value
Available Stat? No
Test code C3C4, C4C8
Performed by? Chemistry
Sendout? no
Price range $$$ each
In House Availability Monday - Friday
Principle T-cells are stained with monoclonal antibodies to specific T-cell subset markers using 4 fluorochromes. Four color analysis is performed by flow cytometry. Cell data produced are measurements of light scatter and fluorescence intensity.
Interpretation CD4/CD8 ratio and absolute CD4

CD4/CD8 ratio and absolute CD4 are meaningful only if patient is HIV-infected. They are useful as prognostic indicators of progression from asymptomatic HIV to ARC and AIDS. They are not diagnostic of HIV, ARC or AIDS. In early stage of progression, decreased CD4/CD8 ratio is usually due to an increased absolute CD8 (or relative decrease in absolute CD4 with a relative increase in absolute CD8). Decreased CD4/CD8 ratio secondary to increased absolute CD8 is also seen in CMV, HBV and EBV infections. Later in the progression of HIV infection, CD4/CD8 ratio becomes low due to a significant decrease in absolute CD4. As absolute lymphopenia develops, CD4/CD8 ratio may rise from its nadir but almost always remains low. CD4/CD8 ratio can be decreased in viral infections, cytotoxic therapy, lympho-proliferative diseases, selective IgA deficiency and common variable immunodeficiency.
Container type EDTA (lavender top) tube
Amount to Collect 1 mL
Sample type Whole blood
Special instructions Keep at room temperature. Do Not Refrigerate. Specimen should be sent to the laboratory immediately.
Normal range Adult:
CD4/CD8 (T Helper/Suppressor Ratio): 0.60 - 3.20

% Lymphs Absolute Cell Count
CD4 (T Helper Cells): 28 - 59% 420-1250 cells/mcL
CD8 (T Suppressor Cells): 17 - 46% 220-960 cells/mcL

Stability Flow Cytometry: 48 hours at room temperature. Specimens are accepted Monday 0800 - Friday 1700. If collection time is unknown, stability and results may be questionable.
Additional information In order to report results for this two-platform flow cytometry method, a CBC with differential is required (for absolute cell counts). A CBC with differential will be ordered on the same sample, if not otherwise available.

CD4 results are automatically forwarded to California Dept of Public Health per State regulations. However, this does not relieve the ordering provider of any responsibility for additional reporting, if such is required.
References 1. Reniz, P., Ginns, L.C.: Analysis of T-cell Subsets in Normal Adults. Comparison of Whole Blood Lysis Technique to Ficoll-Hypaque Separation by Flow Cytometry. Journal of Immunological Methods 98:53-56, 1987.

2. Jackson, A., Warner, N.: Preparation, Staining and Analysis by Flow Cytometry of Peripheral Blood Leukocytes. Manual of Clinical Laboratory Immunology, 3rd ed. Editors: J. Fahey, H. Friedman, N. Rose. 1985.

3. Shapiro, H.: Practical Flow Cytometry. Alan R. Liss, ed. New York, 1985.

4. Moss, A. et al: Seropositivity for HIV and Development of AIDS or ARC: Three-year follow-up of San Francisco General Hospital Cohort. Brit Med J 296:745-750, March 1988.

5. Valenzuela, R. et al: "Check Sample: T-cell Subsets in Patients with HIV Infection," Immunopathology 12:5, 1988.

6. CDC MMWR Morbidity and Mortality Weekly Report, U.S. Government printing office, Washington D.C. Vol. 46 # RR-2, pg. 1-29, 1997.
CPT coding 86361
Last Updated 5/3/2016 8:22:48 AM
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