Which laboratory value is the nurse's priority for a client with HIV?

Which laboratory value is the nurse's priority for a client with HIV?

• A. Positive western blot test
• B. WBC 5,000
• C. CD4-T cell count at 180
• D. Platelets at 150,000

Answer: (C)

In HIV care, the most informative measure of how the virus is affecting the body is the CD4 T-cell count, because it directly reflects immune system status. A CD4 count of 180 cells/mm3 indicates significant immunosuppression and falls below the AIDS-defining threshold of 200, signaling a high risk for opportunistic infections. This value guides urgent clinical decisions, such as starting prophylaxis for Pneumocystis jirovecii pneumonia and other infections and assessing the urgency of optimizing antiretroviral therapy. A positive Western blot confirms HIV infection but does not indicate current immune function. A normal white blood cell count and a normal platelet count do not specifically reflect the degree of immune compromise in HIV, so they’re less informative for assessing immediate infection risk.

In HIV care, the most informative measure of how the virus is affecting the body is the CD4 T-cell count, because it directly reflects immune system status. A CD4 count of 180 cells/mm3 indicates significant immunosuppression and falls below the AIDS-defining threshold of 200, signaling a high risk for opportunistic infections. This value guides urgent clinical decisions, such as starting prophylaxis for Pneumocystis jirovecii pneumonia and other infections and assessing the urgency of optimizing antiretroviral therapy.

A positive Western blot confirms HIV infection but does not indicate current immune function. A normal white blood cell count and a normal platelet count do not specifically reflect the degree of immune compromise in HIV, so they’re less informative for assessing immediate infection risk.