BTSC 3 August 2025
Medical & Surgical Nursing
Easy
In an HIV infection, a diagnosis of AIDS is made when the CD4+ T-cell count falls below which of the following values?
Appeared in: BTSC 3 August 2025
Explanation
- A CD4+ T-cell count falling below 200 cells/mm³ is a primary laboratory criterion for diagnosing Acquired Immunodeficiency Syndrome (AIDS), which is also known as Stage 3 HIV infection.
- This diagnostic threshold is established by the Centers for Disease Control and Prevention (CDC) and is used globally.
- This level of depletion in CD4+ cells indicates severe immunosuppression, making the individual highly susceptible to life-threatening opportunistic infections and specific malignancies.
Why Other Options Were Wrong
- Option B: A CD4 count of 350 cells/mm³ falls within the 200–499 cells/mm³ range, which classifies the patient in CDC Stage 2 of HIV infection. This indicates moderate immunodeficiency, not AIDS.
- Option C: A CD4 count of 800 cells/mm³ is within the normal range for a healthy individual (typically 500-1500 cells/mm³). It signifies a relatively healthy immune system.
- Option D: A CD4 count of 500 cells/mm³ is the threshold for Stage 1 HIV infection (≥500 cells/mm³). A count dropping below this number indicates progression to Stage 2, but it is not the diagnostic criterion for AIDS.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to HIV infection staging based on CD4+ T-cell count to guide bedside assessment, documentation, and the next nursing action.
- Monitoring CD4+ T-cell counts is crucial for staging HIV, guiding treatment decisions, and determining the need for prophylaxis against opportunistic infections (e.g., starting Trimethoprim-Sulfamethoxazole for Pneumocystis pneumonia prophylaxis when the count drops below 200).
- Nurses play a key role in educating patients about the significance of their CD4 count, the importance of strict adherence to antiretroviral therapy (ART) to preserve immune function, and infection prevention strategies.
- What if? If a patient has a CD4 count of 250 cells/mm³ but is diagnosed with an AIDS-defining illness like esophageal candidiasis or Kaposi sarcoma, they are still diagnosed with AIDS (Stage 3 HIV). The presence of such an illness is also a diagnostic criterion, regardless of the CD4 count.
How to Approach the Question
- First, identify the key terms in the question: 'HIV infection,' 'diagnosis of AIDS,' and 'CD4+ T-cell count'.
- The question asks for the specific laboratory value that defines an AIDS diagnosis.
- Recall the CDC classification system for HIV infection, which uses CD4+ T-cell counts to stage the disease.
- Mentally review the stages: Stage 1 is ≥500 cells/mm³, Stage 2 is 200-499 cells/mm³, and Stage 3 (AIDS) is <200 cells/mm³.
- Compare the given options to these stages and select the option that matches the threshold for an AIDS diagnosis.
Concept Tested & Keywords
- Concept Tested: HIV infection staging based on CD4+ T-cell count
- Stem keywords: HIV infection, diagnosis of AIDS, CD4+ T-cell count
- Lead-in keywords: falls below
- Negative lead-in flag: false
Question ID
QzE3QZq0xE1X9990fFW376
Reference Book
E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) p. 15-17
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 1937-1939
E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 262-264
Practise the full BTSC 3 August 2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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