King's College London

Research portal

Does Discordancy Between the CD4 Count and CD4 Percentage in HIV-Positive Individuals Influence Outcomes on Highly Active Antiretroviral Therapy?

Research output: Contribution to journalArticlepeer-review

Mark Gompels, David T. Dunn, Andrew Phillips, Debbie Dooley, Andrew De Burgh Thomas, Jane Anderson, Frank Post, Deenan Pillay, Brian Gazzard, Teresa Hill, Margaret Johnson, Richard Gilson, Loveleen Bansi, Philippa Easterbrook, Martin Fisher, John Walsh, Chloe Orkin, Jonathan Ainsworth, Clifford Leen, Caroline Sabin

Original languageEnglish
Article numberN/A
Pages (from-to)540 - 547
Number of pages8
JournalJournal of Infectious Diseases
Issue number4
Published15 Feb 2012

King's Authors


Introduction. The CD4 count and CD4 percentage (CD4%) are both strong predictors of clinical disease progression in human immunodeficiency virus (HIV). Although individuals may show discordancy between their CD4 count and CD4%, the clinical relevance of this is unclear.

Methods. Discordancy was defined where the CD4% was <10th percentile for a selected CD4 count range (referred to as low discordancy), within the central 80% range (concordant), or >= 90th percentile (high discordancy). Regression methods identified factors associated with low and high discordancy in untreated individuals and assessed the impact of discordancy on treatment responses to highly active antiretroviral therapy (HAART).

Results. High discordancy was associated with female sex, low viral load, and white ethnicity; low discordancy was associated with black or nonwhite ethnicity, older age, and injection drug use. Clinical event rates were higher in individuals with high discordancy starting HAART, but there was no association with subsequent HIV progression by 6 months after starting HAART. CD4 count increases remained lower, by 20 cells/mm(3), in individuals with low discordancy, and higher, by 27 cells/mm(3), in those with high discordancy.

Conclusions. Overall discrepancies between the CD4/CD4% are small, confirming the use of absolute CD4 counts as a monitoring tool.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454