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Things We Do for No Reason™: Routine CD4 testing in hospitalized patients with HIV
Michael R Rose1, Adrienne M Johnson2, Joel N Blankson3
1Division of Clinical Pharmacology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Journal of Hospital Medicine
|January 7, 2026
Summary
CD4 testing during hospitalization for people with human immunodeficiency virus (HIV) is often unhelpful due to temporary stress-induced suppression. Focus on viral suppression and ART adherence for accurate immune status assessment.
Area of Science:
- Infectious Diseases
- Immunology
- Clinical Medicine
Background:
- CD4 testing is standard for hospitalized people with HIV (PWH).
- Acute stressors and medications can temporarily lower CD4 counts, mimicking disease progression.
- Most PWH on antiretroviral therapy (ART) have suppressed viral loads and reconstituted immune systems.
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