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When an AIDS doctor declares that a patient with a CD4 count is “severely immunesuppressed” he is making a prediction based on the CD4 count with near certainty. When a doctor proclaims that an HIV positive person’s CD4 count of 200 or 350 or 500 shows that it is “time to start drugs” they are also making a prediction on the basis of a CD4 count, a prediction with implied certainty. Perhaps, if pressed, the doctor might admit that there are some people with low CD4 counts who are not sick, but the basic message is that CD4 counts have been shown, scientifically, to be highly accurate indicators of your stage of “progression to AIDS” – from asymptomatic to pre-AIDS (“AIDS-related complex”) to full-blown AIDS and then death. But, what is the evidence that CD4 counts are associated with stage of immune suppression? And, how accurate would a prediction that a certain CD4 count indicates that a person is at a particular stage of HIV or AIDS be?
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