Page 20 - Children Bookt.pdf
P. 20
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used in conjunction with clinical assessment; however, CD4 allows an earlier
detection of worsening of HIV disease as CD4 decline usually occurs before there
is clinical progression. CD4 monitoring can aid in the decision to initiate or switch
ART. Younger children normally have higher CD4 than older children and adults.
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months, CD4 is less predictive of mortality and there is high risk for death even
at high %CD4.
Total lymphocyte count ( TLC) is only used if CD4 measurement is not available
and it should only be used to categorize severe immune suppression. Calculation
of TLC = % lymphocyte X total white blood cell count.
The predictive value of lymphocytes count should not be used for the evaluation
of response to ART, because a change in TLC is a poor predictor of treatment
success.
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