Wise Use of Laboratory Testing

Increased likelihood of long-term HIV suppression with contemporary antiretroviral therapy (ART) regimens has resulted in a growing population of patients for whom HIV infection is now a chronic condition. Optimizing the long-term management of such patients includes determining the appropriate frequency of follow-up, including laboratory monitoring. Although CD4-cell counts have traditionally been assessed whenever HIV RNA has been measured, recent data suggest that CD4 results in these patients rarely influence management. In fact, current Department of Health and Human Services guidelines state that in patients with virologic suppression and CD4-cell counts well above the threshold for opportunistic-infection risk, the CD4 count may be m…