CDC CD4/immune classification

As with HIV-positive adults, the most common markers for disease severity and progression in children are CD4 and viral load tests. However, it should be remembered that CD4 counts and viral load results in children should be interpreted differently from adult results.

Children may present with higher viral loads than adults, and CD4 counts are generally higher in children, particularly un infants.

For this reason the CD4 percentage (CD4:CD8 ratio) is a more useful guide to disease progression in children and especially infants that the absolute CD4 count. As a rough guide, a CD4 percentage above 25% generally indicates adequate immune function, and a consistent percentage below 15% indicates current or imminent progression to AIDS.

Monitoring children with HIV infection should take into account signs and symptoms, as well as CD4 counts and viral loads.