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Likelihood Ratio (LR) in Emergency Medicine


CD4 and Lymphocyte count

A 30 yo man from Zambia comes to the ED accompained by his girlfriend, he is HIV positive and he has pneumonia, he never done CD4 count. CD4 count of < 200 signifies a greater risk for opportunistic infections = recovery. I can’t  wait for the reponse of the CD4 count…

How much an absolute lymphocite count (ALC) is predictive for a low CD4 count (< 200)?


Absolute lymphocyte count was predictive of a CD4 count of <200 · 106 cells ⁄ lL in HIV+ patients who present to the ED, necessitating hospital admission. A CD4 count of <200 · 106 cells ⁄ lL is very likely if the ED ALC is <950 · 106 cells ⁄ lL and less likely if the ALC is >1,700 · 106 cells ⁄ lL.


Absolute Lymphocyte Count in the Emergency Department Predicts a Low CD4 Count in Admitted HIV-positive Patients. Napoli AM Acad Emerg Med 2011; 18:385-389

Acute HIV infection: diagnosis and management in the Emergency Department. Wesley HS. Emerg Med Clin N Am 28 (2010) 381–392.

HIV infection and complications in Emergency Medicine. Marco CA. Emerg Med Clin N Am 26 (2008) 367-387

Ciro Paolillo