A patient with HIV — which test is MOST important for monitoring the progression of HIV disease?

Correct answer: D. CD4+ T-cell count (measures immune system status; <200 cells/mm³ = AIDS; <50 = severe immunodeficiency)

• A. Viral load (HIV RNA PCR) measures viral replication and treatment effectiveness — equally important clinically but CD4 count specifically monitors IMMUNE status.
• B. CBC gives overall blood cell counts but not specific HIV disease staging.
• C. INR monitors anticoagulation — not relevant to HIV staging.
• D. Correct. The CD4+ T-CELL COUNT is the most important monitoring test for HIV disease progression. CD4+ cells are the primary targets of HIV. Normal: >500 cells/mm³. <200 cells/mm³ = AIDS (Stage 3 HIV). <50 cells/mm³ = severe immunodeficiency with high risk of opportunistic infections. Dental significance: low CD4 count predicts risk for oral manifestations (candidiasis, hairy leukoplakia, KS, NUP).